Healthcare Provider Details

I. General information

NPI: 1710439344
Provider Name (Legal Business Name): COMPREHENSIVE FAMILY FOOT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2016
Last Update Date: 10/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E ELIZABETH AVE SUITE 13
BETHLEHEM PA
18018-6505
US

IV. Provider business mailing address

75 SUNGLO DR
LEESPORT PA
19533-8673
US

V. Phone/Fax

Practice location:
  • Phone: 610-867-4180
  • Fax: 610-691-0642
Mailing address:
  • Phone: 610-349-6703
  • Fax: 610-691-0642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code211D00000X
TaxonomyPodiatric Assistant
License NumberSC004817L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License NumberSC004817L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberSC004817L
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberSC004817L
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberSC004817L
License Number StatePA
# 6
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC004817L
License Number StatePA
# 7
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberSC004817L
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License NumberSC004817L
License Number StatePA
# 9
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberSC004817L
License Number StatePA
# 10
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberSC004817L
License Number StatePA
# 11
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberSC004817L
License Number StatePA
# 12
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberSC004817L
License Number StatePA
# 13
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberSC004817L
License Number StatePA
# 14
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberSC004817L
License Number StatePA
# 15
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC004817L
License Number StatePA

VIII. Authorized Official

Name: DR. JILL EPSTEIN
Title or Position: OWNER/OPERATOR
Credential: DPM
Phone: 610-349-6703