Provider Demographics
NPI:1770990764
Name:RIBEIRO FOOT AND ANKLE CENTER
Entity type:Organization
Organization Name:RIBEIRO FOOT AND ANKLE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIBEIRO-BACHTELL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-637-9917
Mailing Address - Street 1:4660 KENMORE AVE STE 602
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1300
Mailing Address - Country:US
Mailing Address - Phone:703-637-9917
Mailing Address - Fax:703-566-5201
Practice Address - Street 1:4660 KENMORE AVE STE 602
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1300
Practice Address - Country:US
Practice Address - Phone:703-637-9917
Practice Address - Fax:703-566-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty