Provider Demographics
NPI:1912188376
Name:THE BURKE FOOT AND ANKLE CENTER
Entity Type:Organization
Organization Name:THE BURKE FOOT AND ANKLE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARMINIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-250-2904
Mailing Address - Street 1:5631 BURKE CENTRE PKWY
Mailing Address - Street 2:SUITE K
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2234
Mailing Address - Country:US
Mailing Address - Phone:703-250-2904
Mailing Address - Fax:703-250-2939
Practice Address - Street 1:5631 BURKE CENTRE PKWY
Practice Address - Street 2:STE K
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-2234
Practice Address - Country:US
Practice Address - Phone:703-250-2904
Practice Address - Fax:703-250-2939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000622213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA290564OtherBLUECROSSBLUESHIELD OF VA
VA2382743OtherAETNA HMO
VA223294OtherMDIPA
VA504746OtherNCPPO
VA6659OtherBLUECROSSBLUESHIELD FEP
VA480026207OtherRAILROAD MEDICARE GROUP MEMBER
VADN0667OtherRAILROAD MEDICARE GROUP
VA2035487OtherAETNA
VA6659OtherBLUECROSSBLUESHIELD FEP
VA480026207OtherRAILROAD MEDICARE GROUP MEMBER
VA6659OtherBLUECROSSBLUESHIELD FEP
VAT30889Medicare UPIN