MEDICARE: COMPREHENSIVE FAMILY FOOT CARE, LLC

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	211D00000X	Podiatric Assistant	SC004817L	PA
2	213EP0504X	Public Medicine Podiatrist	SC004817L	PA
3	213EP1101X	Primary Podiatric Medicine Podiatrist	SC004817L	PA
4	213ER0200X	Radiology Podiatrist	SC004817L	PA
5	213ES0000X	Sports Medicine Podiatrist	SC004817L	PA
6	213ES0103X	Foot & Ankle Surgery Podiatrist	SC004817L	PA
7	213ES0131X	Foot Surgery Podiatrist	SC004817L	PA
8	282E00000X	Long Term Care Hospital	SC004817L	PA
9	282N00000X	General Acute Care Hospital	SC004817L	PA
10	310400000X	Assisted Living Facility	SC004817L	PA
11	314000000X	Skilled Nursing Facility	SC004817L	PA
12	315D00000X	Inpatient Hospice	SC004817L	PA
13	332B00000X	Durable Medical Equipment & Medical Supplies	SC004817L	PA
14	335E00000X	Prosthetic/Orthotic Supplier	SC004817L	PA
15	213E00000X	Podiatrist	SC004817L	PA

General Provider Information

NPI Number	:	1710439344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE FAMILY FOOT CARE, LLC

Provider Business Mailing Address
First Line	:	75 SUNGLO DR
Second Line	:
City	:	LEESPORT
State	:	PA
Zip	:	19533-8673
Country	:	US
Telephone Number	:	610-349-6703
Fax Number	:	610-691-0642

Provider Business Practice Location Address
First Line	:	35 E ELIZABETH AVE
Second Line	:	SUITE 13
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-6505
Country	:	US
Telephone Number	:	610-867-4180
Fax Number	:	610-691-0642

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	DR. JILL EPSTEIN
Credential	:	DPM
Telephone Number	:	610-349-6703

Provider Enumeration Date	:	10/31/2016
Last Update Date	:	10/31/2016

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