Provider Demographics
NPI:1659366029
Name:NORTHERN INDIANA FOOT & ANKLE ASSOC INC
Entity Type:Organization
Organization Name:NORTHERN INDIANA FOOT & ANKLE ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZIELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-935-5563
Mailing Address - Street 1:504 COLONIAL CT
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563-1860
Mailing Address - Country:US
Mailing Address - Phone:574-935-5563
Mailing Address - Fax:574-935-0015
Practice Address - Street 1:504 COLONIAL COURT
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563-1860
Practice Address - Country:US
Practice Address - Phone:574-935-5563
Practice Address - Fax:574-935-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN083950Medicare ID - Type Unspecified