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General NPI Number Information
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NPI Number | 1952883753
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLC
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Dates
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Enumeration Date | 08/29/2018
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 2050 ABBEY RD STE C
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22911-3553
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Country | US
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Telephone | 434-295-4443
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 825159
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City | PHILADELPHIA
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State | PA
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Zip | 19182-5159
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Country | US
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Telephone | 314-909-1920
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL TRITTO
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Credential |
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Telephone | 301-933-7133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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