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NPI Code Detail

MEDICARE: GENE PUSATERI DPM INC

MEDICARE: GENE PUSATERI DPM INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatrist36001684OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386702108
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENE PUSATERI DPM INC
Provider Business Mailing Address
First Line : 80 E MIDLOTHIAN BLVD
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44507-2019
Country : US
Telephone Number : 330-782-6113
Fax Number : 330-782-9676
Provider Business Practice Location Address
First Line : 80 E MIDLOTHIAN BLVD
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44507-2019
Country : US
Telephone Number : 330-782-6113
Fax Number : 330-782-9676
Authorized Official
Title or Position : PRESIDENT
Name : DR. GENE J. PUSATERI
Credential : D.P.M.
Telephone Number : 330-782-6113
Provider Enumeration Date : 12/05/2006
Last Update Date : 03/22/2016

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