MEDICARE: GENE LINETSKY,DPM,PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	SC004371-L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	U67143	OTHER	PA	UPIN

General Provider Information

NPI Number	:	1386822534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENE LINETSKY,DPM,PC

Provider Business Mailing Address
First Line	:	162 PHEASANT LN
Second Line	:
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-3105
Country	:	US
Telephone Number	:	215-947-7350
Fax Number	:

Provider Business Practice Location Address
First Line	:	162 PHEASANT LN
Second Line	:
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-3105
Country	:	US
Telephone Number	:	215-947-7350
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GENE LINETSKY
Credential	:	DPM
Telephone Number	:	215-947-7350

Provider Enumeration Date	:	02/08/2008
Last Update Date	:	02/08/2008

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