Provider Demographics
NPI:1205020179
Name:VERONA FOOT CARE LLC
Entity Type:Organization
Organization Name:VERONA FOOT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:412-794-8544
Mailing Address - Street 1:600 W RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-1140
Mailing Address - Country:US
Mailing Address - Phone:412-794-8544
Mailing Address - Fax:412-794-8550
Practice Address - Street 1:600 W RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-1140
Practice Address - Country:US
Practice Address - Phone:412-794-8544
Practice Address - Fax:412-794-8550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC 003192 L213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29236Medicare UPIN
PA072496Medicare PIN