Healthcare Provider Details

I. General information

NPI: 1932013752
Provider Name (Legal Business Name): FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 FLOWERS DR STE 2
MECHANICSBURG PA
17050-1709
US

IV. Provider business mailing address

4 FLOWERS DR STE 2
MECHANICSBURG PA
17050-1709
US

V. Phone/Fax

Practice location:
  • Phone: 717-620-8225
  • Fax:
Mailing address:
  • Phone: 717-620-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL TRITTO
Title or Position: AUTHORIZED OFFICIAL
Credential: DPM
Phone: 301-933-7133