MEDICARE: A1 FOOT AND ANKLE CLINIC

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
1	213EP1101X	Primary Podiatric Medicine Podiatrist	SC005921	PA
2	213ER0200X	Radiology Podiatrist	SC005921	PA
3	213ES0103X	Foot & Ankle Surgery Podiatrist	SC005921	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	137985	OTHER	PA	MEDICARE PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1568854412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A1 FOOT AND ANKLE CLINIC

Provider Business Mailing Address
First Line	:	2130 FREEPORT RD
Second Line	:	SUITE A
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1542
Country	:	US
Telephone Number	:	724-224-2498
Fax Number	:	724-224-1192

Provider Business Practice Location Address
First Line	:	2130 FREEPORT RD
Second Line	:	SUITE A
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1542
Country	:	US
Telephone Number	:	724-224-2498
Fax Number	:	724-224-1192

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	CHERYL LYNN GOLDSTEIN
Credential	:	M.ED., DPM
Telephone Number	:	724-224-2498

Provider Enumeration Date	:	03/02/2015
Last Update Date	:	03/02/2015

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Directions to “A1 FOOT AND ANKLE CLINIC ” Practice Location

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