Provider Demographics
NPI:1972516243
Name:TRI-COUNTY FOOT
Entity Type:Organization
Organization Name:TRI-COUNTY FOOT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:PONGIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-326-0453
Mailing Address - Street 1:1800 E HIGH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3239
Mailing Address - Country:US
Mailing Address - Phone:610-326-0453
Mailing Address - Fax:610-326-3144
Practice Address - Street 1:1800 E HIGH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3239
Practice Address - Country:US
Practice Address - Phone:610-326-0453
Practice Address - Fax:610-326-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA510551OtherBLUE SHIELD
PA510551Medicare PIN
PAT30548Medicare UPIN
PA480019040Medicare Oscar/Certification
PA510551OtherBLUE SHIELD
PA480019039Medicare Oscar/Certification