Provider Demographics
NPI:1770598567
Name:MARK E PINKER
Entity type:Organization
Organization Name:MARK E PINKER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:PINKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-243-2236
Mailing Address - Street 1:47 BROOKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015
Mailing Address - Country:US
Mailing Address - Phone:717-243-2236
Mailing Address - Fax:717-243-6536
Practice Address - Street 1:47 BROOKWOOD AVE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-9266
Practice Address - Country:US
Practice Address - Phone:717-243-2236
Practice Address - Fax:717-243-6536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1159530001Medicare NSC
PA120643Medicare PIN