Provider Demographics
NPI:1841537222
Name:FAMILY FOOT AND ANKLE CARE OF DELAWARE, LLC
Entity type:Organization
Organization Name:FAMILY FOOT AND ANKLE CARE OF DELAWARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:V
Authorized Official - Last Name:BAKANAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:302-898-3873
Mailing Address - Street 1:306 ODESSA AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-1439
Mailing Address - Country:US
Mailing Address - Phone:302-898-3873
Mailing Address - Fax:
Practice Address - Street 1:18947 JOHN J WILLIAMS HWY
Practice Address - Street 2:311
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4474
Practice Address - Country:US
Practice Address - Phone:302-898-3873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-06
Last Update Date:2013-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE1-0000186213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty