Provider Demographics
NPI:1710008214
Name:ABSOLUTE FOOT CARE
Entity Type:Organization
Organization Name:ABSOLUTE FOOT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:D
Authorized Official - Last Name:COZZOLINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM,FACFAS
Authorized Official - Phone:740-816-3153
Mailing Address - Street 1:495 COOPER RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-8780
Mailing Address - Country:US
Mailing Address - Phone:740-816-3153
Mailing Address - Fax:614-898-8647
Practice Address - Street 1:495 COOPER RD
Practice Address - Street 2:SUITE 230
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-8780
Practice Address - Country:US
Practice Address - Phone:740-816-3153
Practice Address - Fax:614-898-8647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003394213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1336215623OtherPERSONAL NPI
OH56911Medicare UPIN