Healthcare Provider Details

I. General information

NPI: 1841349438
Provider Name (Legal Business Name): FRANKFORD PODIATRY ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 PRATT ST
PHILADELPHIA PA
19124-1923
US

IV. Provider business mailing address

1546 PRATT ST
PHILADELPHIA PA
19124-1923
US

V. Phone/Fax

Practice location:
  • Phone: 215-533-8555
  • Fax: 215-533-8656
Mailing address:
  • Phone: 215-533-8555
  • Fax: 215-533-8656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number StatePA

VIII. Authorized Official

Name: DR. KETAN H KOTHARI
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 215-533-8555