Provider Demographics
NPI:1982638714
Name:FOOT HEALTH CENTERS, P.A,
Entity Type:Organization
Organization Name:FOOT HEALTH CENTERS, P.A,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-795-1003
Mailing Address - Street 1:52 BERLIN RD
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3574
Mailing Address - Country:US
Mailing Address - Phone:856-795-1003
Mailing Address - Fax:856-795-5994
Practice Address - Street 1:52 BERLIN RD
Practice Address - Street 2:SUITE 5000
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3574
Practice Address - Country:US
Practice Address - Phone:856-795-1003
Practice Address - Fax:856-795-5994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3255708OtherAETNA
PA0005060840001Medicaid
PA0060618000OtherKEYSTONE HEALTH PLAN EAST
PA20770OtherHEALTH PARTNERS
NJ2808307Medicaid
NJ6200055OtherGROUP HEALTH INSURANCE
NJ0421600000OtherAMERIHEALTH
PA20770OtherHEALTH PARTNERS
PA0060618000OtherKEYSTONE HEALTH PLAN EAST
NJ0509880005Medicare NSC
NJ0421600000OtherAMERIHEALTH