Provider Demographics
NPI:1902826829
Name:BERKS FOOT AND ANKLE SURGICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:BERKS FOOT AND ANKLE SURGICAL ASSOCIATES, INC
Other - Org Name:HAMBURG PODIATRY CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUZIE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SATTIZAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-796-9522
Mailing Address - Street 1:260 STATE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-1823
Mailing Address - Country:US
Mailing Address - Phone:610-562-4999
Mailing Address - Fax:610-562-0221
Practice Address - Street 1:260 STATE ST STE 2
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-1823
Practice Address - Country:US
Practice Address - Phone:610-562-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERKS FOOT & ANKLE SURGICAL ASSOC., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-21
Last Update Date:2024-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002677-L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
668116OtherHIGHMARK BLUE SHIELD
02340800OtherCAPITOL BLUE CROSS
668116OtherMEDICARE
PA0010441170005Medicaid
PA20017609OtherAMERIHEALTH
PA2101100000OtherINDEPENDENCE BLUE CROSS
668116OtherHIGHMARK BLUE SHIELD
PA20017609OtherAMERIHEALTH