Provider Demographics
NPI:1477297992
Name:PELLESCHI FOOT & ANKLE SPECIALISTS LLC
Entity Type:Organization
Organization Name:PELLESCHI FOOT & ANKLE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:RYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:717-938-5200
Mailing Address - Street 1:689 YORKTOWN RD STE 205
Mailing Address - Street 2:
Mailing Address - City:LEWISBERRY
Mailing Address - State:PA
Mailing Address - Zip Code:17339-9258
Mailing Address - Country:US
Mailing Address - Phone:717-938-5200
Mailing Address - Fax:
Practice Address - Street 1:689 YORKTOWN RD STE 205
Practice Address - Street 2:
Practice Address - City:LEWISBERRY
Practice Address - State:PA
Practice Address - Zip Code:17339-9258
Practice Address - Country:US
Practice Address - Phone:717-938-5200
Practice Address - Fax:717-938-5230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty