Healthcare Provider Details

I. General information

NPI: 1336002443
Provider Name (Legal Business Name): FIRST STEP PODIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 LAVOIE DR
NOTTINGHAM NH
03290-5522
US

IV. Provider business mailing address

2093 PHILADELPHIA PIKE STE 9775
CLAYMONT DE
19703-2424
US

V. Phone/Fax

Practice location:
  • Phone: 484-707-8420
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE STARK
Title or Position: AUTHORIZED OFFICIAL
Credential: DPM
Phone: 484-707-8420