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General NPI Number Information
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NPI Number | 1356734693
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Entity Type | Organization
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Legal Business Name | STEWARTSTOWN PODIATRY
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Dates
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Enumeration Date | 03/11/2015
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 96 SOFIA DR STE 205
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City | SHREWSBURY
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State | PA
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Zip | 17361-5201
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Country | US
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Telephone | 717-781-8313
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Fax |
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Provider Business Mailing Address
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Address Line | 416 BELFAST RD
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City | SPARKS
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State | MD
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Zip | 21152-9133
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Country | US
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Telephone | 717-993-7411
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TANIA NICOLE BURINSKAS
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Credential |
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Telephone | 717-781-8313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC006381
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License Number State | PA
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