Healthcare Provider Details
I. General information
NPI: 1255376307
Provider Name (Legal Business Name): HEALTHMARK FOOT AND ANKLE ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2006
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 N MONROE ST
MEDIA PA
19063-3037
US
IV. Provider business mailing address
101 N MONROE ST
MEDIA PA
19063-3037
US
V. Phone/Fax
- Phone: 610-565-3668
- Fax: 610-565-9722
- Phone: 610-565-3668
- Fax: 610-565-9722
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NICHOLAS
M
ROMANSKY
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 610-565-3668