Provider Demographics
NPI:1417259938
Name:BARKINGDOGS FOOT AND ANKLE CARE, PC
Entity Type:Organization
Organization Name:BARKINGDOGS FOOT AND ANKLE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PAGANO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:484-681-9485
Mailing Address - Street 1:1000 GERMANTOWN PIKE
Mailing Address - Street 2:SUITE C3
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2480
Mailing Address - Country:US
Mailing Address - Phone:484-681-9485
Mailing Address - Fax:484-681-9487
Practice Address - Street 1:1000 GERMANTOWN PIKE
Practice Address - Street 2:SUITE C3
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2480
Practice Address - Country:US
Practice Address - Phone:484-681-9485
Practice Address - Fax:484-681-9487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-04
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005966213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6582700001Medicare NSC