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General NPI Number Information
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NPI Number | 1669701413
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Entity Type | Organization
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Legal Business Name | ADVANCED FOOT & ANKLE ASSOCIATES
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 1000 S. MERCER ST. 4TH FLOOR JAMESON SOUTH
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City | NEW CASTLE
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State | PA
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Zip | 16101-4672
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Country | US
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Telephone | 724-654-5433
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Fax | 724-654-3278
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Provider Business Mailing Address
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Address Line | 1000 S. MERCER ST. 4TH FLOOR JAMESON SOUTH
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City | NEW CASTLE
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State | PA
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Zip | 16101-4672
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Country | US
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Telephone | 724-654-5433
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Fax | 724-654-3278
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW LIWSKI
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Credential | DPM
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Telephone | 724-654-5433
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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 | SC005768
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License Number State | PA
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