Provider Demographics
NPI:1841349438
Name:FRANKFORD PODIATRY ASSOCIATES, PC
Entity type:Organization
Organization Name:FRANKFORD PODIATRY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KETAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KOTHARI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-533-8555
Mailing Address - Street 1:1546 PRATT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19124-1923
Mailing Address - Country:US
Mailing Address - Phone:215-533-8555
Mailing Address - Fax:215-533-8656
Practice Address - Street 1:1546 PRATT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-1923
Practice Address - Country:US
Practice Address - Phone:215-533-8555
Practice Address - Fax:215-533-8656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1425122Medicaid
PA0060837000OtherPA. BLUE SHIELD
PA30003475OtherKEYSTONE MERCY
PA01530OtherHEALTH PARTNERS
PA0060837000OtherPA. BLUE SHIELD