Provider Demographics
NPI:1457529877
Name:GINA M SAFFO DPM CHARTERED
Entity Type:Organization
Organization Name:GINA M SAFFO DPM CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAFFO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-577-4464
Mailing Address - Street 1:5900 PRINCESS GARDEN PKWY STE 420
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-2952
Mailing Address - Country:US
Mailing Address - Phone:301-577-4464
Mailing Address - Fax:301-577-4702
Practice Address - Street 1:5900 PRINCESS GARDEN PKWY STE 420
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2952
Practice Address - Country:US
Practice Address - Phone:301-577-4464
Practice Address - Fax:301-577-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01021332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD428699Medicare PIN
MD5927570001Medicare NSC
MDT84728Medicare UPIN