Provider Demographics
NPI:1134759681
Name:ARYA FOOT & ANKLE
Entity type:Organization
Organization Name:ARYA FOOT & ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHYLAJA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARYA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:440-552-5889
Mailing Address - Street 1:3104 E INDIAN SCHOOL RD STE 110
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-6873
Mailing Address - Country:US
Mailing Address - Phone:602-309-8788
Mailing Address - Fax:
Practice Address - Street 1:3104 E INDIAN SCHOOL RD STE 110
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6873
Practice Address - Country:US
Practice Address - Phone:602-309-8788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZPOD-000940OtherARIZONA LICENSE