Provider Demographics
NPI:1023691177
Name:FOOTCARE HOME VISITS
Entity type:Organization
Organization Name:FOOTCARE HOME VISITS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CANUSO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-780-0779
Mailing Address - Street 1:406 HAZELWOOD LN
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4706
Mailing Address - Country:US
Mailing Address - Phone:856-780-0779
Mailing Address - Fax:
Practice Address - Street 1:40 W KINGS HWY
Practice Address - Street 2:
Practice Address - City:MOUNT EPHRAIM
Practice Address - State:NJ
Practice Address - Zip Code:08059-1303
Practice Address - Country:US
Practice Address - Phone:856-780-0779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty