Provider Demographics
NPI:1821095480
Name:CHERRY TREE FOOT AND ANKLE SPECIALISTS, PC
Entity Type:Organization
Organization Name:CHERRY TREE FOOT AND ANKLE SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-630-8100
Mailing Address - Street 1:798 CHERRY TREE CT
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-7901
Mailing Address - Country:US
Mailing Address - Phone:717-630-8100
Mailing Address - Fax:717-630-2800
Practice Address - Street 1:798 CHERRY TREE CT
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-7901
Practice Address - Country:US
Practice Address - Phone:717-630-8100
Practice Address - Fax:717-630-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1446958OtherHIGHMARK BLUE SHIELD
PA50008502OtherCAPITAL BLUECROSS
PA50008502OtherCAPITAL BLUECROSS
PA4762890001Medicare NSC