Healthcare Provider Details
I. General information
NPI: 1316275399
Provider Name (Legal Business Name): WESTMORELAND FOOT & ANKLE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/02/2009
Last Update Date: 12/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 MICHIGAN AVE
JEANNETTE PA
15644-2433
US
IV. Provider business mailing address
700 PELLIS RD
GREENSBURG PA
15601-4488
US
V. Phone/Fax
- Phone: 724-832-1000
- Fax: 724-837-4830
- Phone: 724-832-1000
- Fax: 724-837-4830
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0000X |
| Taxonomy | Sports Medicine Podiatrist |
| License Number | SC005504 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | SC005504 |
| License Number State | PA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | SC005504 |
| License Number State | PA |
VIII. Authorized Official
Name: DR.
CHERRIE
FABRY
CINDRIC
Title or Position: OWNER
Credential: DPM
Phone: 724-832-1000