Provider Demographics
NPI:1720393721
Name:THE FOOT AND ANKLE INSTITUTE OF WESTERN PENNSYLVANIA
Entity Type:Organization
Organization Name:THE FOOT AND ANKLE INSTITUTE OF WESTERN PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDICINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-858-7691
Mailing Address - Street 1:2566 HAYMAKER RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3517
Mailing Address - Country:US
Mailing Address - Phone:412-858-7698
Mailing Address - Fax:412-858-4372
Practice Address - Street 1:2566 HAYMAKER RD
Practice Address - Street 2:SUITE 211
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3517
Practice Address - Country:US
Practice Address - Phone:412-858-7698
Practice Address - Fax:412-858-4372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty