Provider Demographics
NPI:1619373016
Name:OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP,LLC
Entity Type:Organization
Organization Name:OHIO PODIATRIC PHYSICIANS AND SURGEONS GROUP,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:F
Authorized Official - Last Name:CHIARAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-923-0506
Mailing Address - Street 1:615 PORTAGE TRL
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3001
Mailing Address - Country:US
Mailing Address - Phone:330-923-0506
Mailing Address - Fax:330-923-0516
Practice Address - Street 1:615 PORTAGE TRL
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3001
Practice Address - Country:US
Practice Address - Phone:330-923-0506
Practice Address - Fax:330-923-0516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-12
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.002920213EP1101X, 213ES0103X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty