Provider Demographics
NPI:1326771619
Name:DOCTOR CRAIG LLC
Entity Type:Organization
Organization Name:DOCTOR CRAIG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:PARUSZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-381-1322
Mailing Address - Street 1:835 W CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-4848
Mailing Address - Country:US
Mailing Address - Phone:856-671-2483
Mailing Address - Fax:
Practice Address - Street 1:835 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-4848
Practice Address - Country:US
Practice Address - Phone:856-671-2483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASC006965OtherPENNSYLVANIA