Provider Demographics
NPI:1114196235
Name:JANICE POSTAL DPM
Entity Type:Organization
Organization Name:JANICE POSTAL DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:POSTAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-681-6008
Mailing Address - Street 1:1111 SPRING ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4003
Mailing Address - Country:US
Mailing Address - Phone:301-681-6008
Mailing Address - Fax:301-681-8908
Practice Address - Street 1:1111 SPRING ST
Practice Address - Street 2:SUITE 214
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4003
Practice Address - Country:US
Practice Address - Phone:301-681-6008
Practice Address - Fax:301-681-8908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD479168100Medicaid
MDT30943Medicare UPIN
MD480007581Medicare PIN
MD4058710001Medicare NSC
MD152716Medicare PIN