Provider Demographics
NPI:1619212511
Name:GERALD STEINES, DPM LLC
Entity Type:Organization
Organization Name:GERALD STEINES, DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:,GERALD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:STEINES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:724-843-8791
Mailing Address - Street 1:1626 7TH AVE
Mailing Address - Street 2:PO BOX 46
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-4058
Mailing Address - Country:US
Mailing Address - Phone:724-843-8791
Mailing Address - Fax:724-843-4009
Practice Address - Street 1:1626 7TH AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4058
Practice Address - Country:US
Practice Address - Phone:724-843-8791
Practice Address - Fax:724-843-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001439L261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1501561Medicaid
PAT27009Medicare UPIN
PA002410Medicare PIN