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General NPI Number Information
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NPI Number | 1760768436
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Entity Type | Organization
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Legal Business Name | JEFFREY T MOLINARO DPM PC
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Dates
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Enumeration Date | 10/26/2011
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Last Update Date | 10/26/2011
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Provider Practice Location Address
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Address Line | 101 DIXIE DR
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City | OAKDALE
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State | PA
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Zip | 15071-1516
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Country | US
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Telephone | 412-787-8380
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Fax | 412-787-8380
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Provider Business Mailing Address
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Address Line | 101 DIXIE DR
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City | OAKDALE
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State | PA
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Zip | 15071-1516
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Country | US
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Telephone | 412-787-8380
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Fax | 412-787-8380
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY T MOLINARO
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Credential | DPM
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Telephone | 412-787-8380
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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 | SC-003779R
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License Number State | PA
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