Provider Demographics
NPI:1689248445
Name:UNIVERSITY FOOT & ANKLE CENTER INC
Entity Type:Organization
Organization Name:UNIVERSITY FOOT & ANKLE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:SARDELLA
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:401-861-8830
Mailing Address - Street 1:1180 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-2034
Mailing Address - Country:US
Mailing Address - Phone:401-861-8830
Mailing Address - Fax:
Practice Address - Street 1:1180 SMITH ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-2034
Practice Address - Country:US
Practice Address - Phone:401-861-8830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY FOOT & ANKLE CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty