Provider Demographics
NPI:1568109098
Name:BKS PODIATRY FOOT CARE SPECIALISTS
Entity Type:Organization
Organization Name:BKS PODIATRY FOOT CARE SPECIALISTS
Other - Org Name:BKS PODIATRY FOOTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BARAKA
Authorized Official - Middle Name:KWIZERA
Authorized Official - Last Name:SENZIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-921-7083
Mailing Address - Street 1:1900 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-1127
Mailing Address - Country:US
Mailing Address - Phone:717-921-7083
Mailing Address - Fax:717-842-2345
Practice Address - Street 1:1900 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-1127
Practice Address - Country:US
Practice Address - Phone:717-921-7083
Practice Address - Fax:717-842-2345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty