Provider Demographics
NPI:1740243922
Name:A FOOT ABOVE PODIATRY, INC.
Entity Type:Organization
Organization Name:A FOOT ABOVE PODIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONACO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-446-1392
Mailing Address - Street 1:1120 TOWNSHIP LINE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-3431
Mailing Address - Country:US
Mailing Address - Phone:610-446-1392
Mailing Address - Fax:610-449-2933
Practice Address - Street 1:1120 TOWNSHIP LINE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3431
Practice Address - Country:US
Practice Address - Phone:610-446-1392
Practice Address - Fax:610-449-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2126580000OtherKEYSTONE HEALTH PLAN EAST
PA30003681OtherKEYSTONE MERCY
PA3059832OtherAETNA
PA1441884OtherPA BLUE SHIELD
PA3059832OtherAETNA
PA4801220001Medicare NSC