Provider Demographics
NPI:1649890724
Name:HORSHAM FOOT AND ANKLE
Entity type:Organization
Organization Name:HORSHAM FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-443-5709
Mailing Address - Street 1:10 CATHARINE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-4312
Mailing Address - Country:US
Mailing Address - Phone:215-443-5709
Mailing Address - Fax:215-443-5716
Practice Address - Street 1:499 HORSHAM RD STE C
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2070
Practice Address - Country:US
Practice Address - Phone:215-443-5709
Practice Address - Fax:215-443-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-20
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty