=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396744413
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AFFILIATES IN PODIATRY PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2005
-----------------------------------------------------
Last Update Date | 09/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 248 PLEASANT ST STE 203
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | NH
-----------------------------------------------------
Zip | 03301-2588
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-225-5281
-----------------------------------------------------
Fax | 603-228-7095
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 825159
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19182-5159
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-626-1540
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DPM
-----------------------------------------------------
Name | JORDAN MEYERS
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 603-225-5281
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NH
-----------------------------------------------------