Provider Demographics
NPI:1710911912
Name:WILLIAM H. LENZ, DPM, PC
Entity Type:Organization
Organization Name:WILLIAM H. LENZ, DPM, PC
Other - Org Name:LENZ KRULJAC DISTAZIO DPMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-461-1108
Mailing Address - Street 1:495 WATERFRONT DR E
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-1140
Mailing Address - Country:US
Mailing Address - Phone:412-461-1108
Mailing Address - Fax:412-461-5490
Practice Address - Street 1:495 WATERFRONT DR E
Practice Address - Street 2:SUITE 230
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-1140
Practice Address - Country:US
Practice Address - Phone:412-461-1108
Practice Address - Fax:412-461-5490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1366414088OtherINDIVIDUAL NPI JOHN DISTAZIO
PA1972582476OtherINDIVIDUAL NPI KATHLEEN O'CONNELL
PAT30166OtherUPIN WILLIAM LENZ
PA1861464836OtherINDIVIDUAL NPI STEPHEN KRULJAC
PA1760454326OtherINDIVIDUAL NPI WILLIAM LENZ
PA455619OtherBLUE SHIELD PROVIDER NUMBER
PAT28597OtherUPIN STEPHEN KRULJAC
PAT29930OtherUPIN JOHN DISTAZIO