Provider Demographics
NPI:1497937239
Name:PODIATRY LTD
Entity Type:Organization
Organization Name:PODIATRY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PLON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-635-6318
Mailing Address - Street 1:601 STETSON RD
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2524
Mailing Address - Country:US
Mailing Address - Phone:215-635-6318
Mailing Address - Fax:215-635-2215
Practice Address - Street 1:601 STETSON RD
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-2524
Practice Address - Country:US
Practice Address - Phone:215-635-6318
Practice Address - Fax:215-635-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002198L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T29820Medicare UPIN
PA0972270001Medicare NSC
PA143101Medicare PIN