Healthcare Provider Details

I. General information

NPI: 1174918577
Provider Name (Legal Business Name): HEALTHMARK FOOT AND ANKLE ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 08/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 W LINCOLN HWY
EXTON PA
19341-2547
US

IV. Provider business mailing address

101 N MONROE ST
MEDIA PA
19063-3037
US

V. Phone/Fax

Practice location:
  • Phone: 610-269-4610
  • Fax: 610-269-4190
Mailing address:
  • Phone: 610-565-3668
  • Fax: 610-565-9722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberSC003145L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberSC003145L
License Number StatePA

VIII. Authorized Official

Name: DR. NICHOLAS MARK ROMANSKY
Title or Position: OWNER
Credential: DPM
Phone: 610-565-3668