MEDICARE: GENE LINETSKY DPM

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	SC004371L	PA

General Provider Information

NPI Number	:	1831151679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENE LINETSKY DPM

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	07/08/2007

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