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General NPI Number Information
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NPI Number | 1336264951
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Entity Type | Organization
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Legal Business Name | BAYSIDE FOOT & ANKLE CENTER
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 8023 RITCHIE HWY
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City | PASADENA
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State | MD
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Zip | 21122-7107
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Country | US
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Telephone | 410-761-4190
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Fax | 410-761-0265
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Provider Business Mailing Address
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Address Line | 8023 RITCHIE HWY
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City | PASADENA
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State | MD
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Zip | 21122-7107
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Country | US
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Telephone | 410-761-4190
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Fax | 410-761-0265
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROSS SAMUEL COHEN
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Credential | D.P.M.
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Telephone | 410-761-4190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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