Provider Demographics
NPI:1376682153
Name:DR MARC JAY PINSKY PC
Entity Type:Organization
Organization Name:DR MARC JAY PINSKY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:PINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-732-6000
Mailing Address - Street 1:PO BOX 1853
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-0853
Mailing Address - Country:US
Mailing Address - Phone:804-732-6000
Mailing Address - Fax:804-861-6558
Practice Address - Street 1:3333 S CRATER RD
Practice Address - Street 2:SUITE 3E
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9276
Practice Address - Country:US
Practice Address - Phone:804-732-6000
Practice Address - Fax:804-861-6558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6212400001Medicare NSC