Provider Demographics
NPI:1245402767
Name:FAMILY FOOT & ANKLE ASSOCIATES OF MARYLAND, PA
Entity Type:Organization
Organization Name:FAMILY FOOT & ANKLE ASSOCIATES OF MARYLAND, PA
Other - Org Name:GROMAN & RUBIN, DPM PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-924-5044
Mailing Address - Street 1:3408 OLANDWOOD COURT
Mailing Address - Street 2:SUITE 226
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1513
Mailing Address - Country:US
Mailing Address - Phone:301-924-5044
Mailing Address - Fax:301-924-5933
Practice Address - Street 1:10801 LOCKWOOD DR STE 260
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1559
Practice Address - Country:US
Practice Address - Phone:301-439-0300
Practice Address - Fax:301-681-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD410205Medicare PIN
MD0334120001Medicare NSC
MD0334120001Medicare NSC