Provider Demographics
NPI:1114193414
Name:CHOICE PODIATRY ASSOCIATES INC
Entity Type:Organization
Organization Name:CHOICE PODIATRY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:T
Authorized Official - Last Name:FEIST
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:513-574-2424
Mailing Address - Street 1:PO BOX 933400
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0038
Mailing Address - Country:US
Mailing Address - Phone:513-574-2424
Mailing Address - Fax:513-574-2479
Practice Address - Street 1:4455 BRIDGETOWN RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-4442
Practice Address - Country:US
Practice Address - Phone:513-574-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002650213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4419150001Medicare NSC