Healthcare Provider Details
I. General information
NPI: 1902555022
Provider Name (Legal Business Name): EULANO FOOT AND ANKLE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/23/2022
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4350 N 19TH AVE STE 3
PHOENIX AZ
85015-4602
US
IV. Provider business mailing address
8575 E PRINCESS DR STE 221
SCOTTSDALE AZ
85255-5441
US
V. Phone/Fax
- Phone: 602-279-4975
- Fax:
- Phone: 490-948-8754
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALBERT
E
EULANO
Title or Position: OWNER
Credential: DPM
Phone: 480-948-8754