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General NPI Number Information
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NPI Number | 1467490169
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Entity Type | Organization
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Legal Business Name | BENSALEM PODIATRY ASSOC.
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 1950 STREET RD SUITE 101
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City | BENSALEM
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State | PA
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Zip | 19020-3755
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Country | US
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Telephone | 215-245-0873
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Fax | 215-245-4011
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Provider Business Mailing Address
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Address Line | 1950 STREET RD SUITE 101
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City | BENSALEM
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State | PA
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Zip | 19020-3755
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Country | US
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Telephone | 215-245-0873
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Fax | 215-245-4011
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Authorized Official
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Title or Position | PRES
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Name | DR. FRED BIRNBAUM
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Credential | DPM
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Telephone | 215-245-0873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 213ES0103X
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License Number State | PA
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