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General NPI Number Information
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NPI Number | 1841537222
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Entity Type | Organization
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Legal Business Name | FAMILY FOOT AND ANKLE CARE OF DELAWARE, LLC
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Dates
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Enumeration Date | 01/06/2013
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Last Update Date | 01/06/2013
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Provider Practice Location Address
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Address Line | 18947 JOHN J WILLIAMS HWY 311
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City | REHOBOTH BEACH
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State | DE
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Zip | 19971-4474
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Country | US
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Telephone | 302-898-3873
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Fax |
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Provider Business Mailing Address
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Address Line | 306 ODESSA AVE
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City | WILMINGTON
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State | DE
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Zip | 19809-1439
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Country | US
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Telephone | 302-898-3873
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSEPH V. BAKANAS
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Credential | D.P.M.
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Telephone | 302-898-3873
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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 | E1-0000186
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License Number State | DE
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