Provider Demographics
NPI:1356734693
Name:STEWARTSTOWN PODIATRY
Entity type:Organization
Organization Name:STEWARTSTOWN PODIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:BURINSKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-781-8313
Mailing Address - Street 1:416 BELFAST RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9133
Mailing Address - Country:US
Mailing Address - Phone:717-993-7411
Mailing Address - Fax:
Practice Address - Street 1:96 SOFIA DR STE 205
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:PA
Practice Address - Zip Code:17361-5201
Practice Address - Country:US
Practice Address - Phone:717-781-8313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006381213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty