Healthcare Provider Details

I. General information

NPI: 1992704977
Provider Name (Legal Business Name): TOM M. KANE D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8101 PERRY HWY
PITTSBURGH PA
15237-5213
US

IV. Provider business mailing address

630 NORTHAVEN CIR
GLENSHAW PA
15116-1960
US

V. Phone/Fax

Practice location:
  • Phone: 412-367-3233
  • Fax: 412-367-5733
Mailing address:
  • Phone: 412-492-7842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC001532L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: