Healthcare Provider Details

I. General information

NPI: 1588615587
Provider Name (Legal Business Name): HARRISBURG FOOT AND ANKLE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2006
Last Update Date: 06/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4033 LINGLESTOWN RD SUITE 1
HARRISBURG PA
17112-1153
US

IV. Provider business mailing address

4033 LINGLESTOWN RD SUITE 1
HARRISBURG PA
17112-1153
US

V. Phone/Fax

Practice location:
  • Phone: 717-651-0000
  • Fax: 717-651-0001
Mailing address:
  • Phone: 717-651-0000
  • Fax: 717-651-0001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANNETTE GROSSMAN
Title or Position: TREASURER
Credential:
Phone: 717-651-0000