Provider Demographics
NPI:1891072849
Name:ANDREW P OSTAPCHUK DPM PA
Entity Type:Organization
Organization Name:ANDREW P OSTAPCHUK DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:KORCZYNSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-743-0410
Mailing Address - Street 1:210 JUPITER LAKES BLVD
Mailing Address - Street 2:SUITE 3101
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7191
Mailing Address - Country:US
Mailing Address - Phone:561-743-0410
Mailing Address - Fax:561-745-3008
Practice Address - Street 1:210 JUPITER LAKES BLVD
Practice Address - Street 2:SUITE 3101
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7191
Practice Address - Country:US
Practice Address - Phone:561-743-0410
Practice Address - Fax:561-745-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-04
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU09596Medicare UPIN