MEDICARE: DR. MARK TIRONE, DPM, 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	213ES0103X	Foot & Ankle Surgery Podiatrist	MD001864	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861532483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MARK TIRONE, DPM, LLC

Provider Business Mailing Address
First Line	:	275 HADDON AVE
Second Line	:
City	:	COLLINGSWOOD
State	:	NJ
Zip	:	08108-1121
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 HADDON AVE
Second Line	:
City	:	COLLINGSWOOD
State	:	NJ
Zip	:	08108-1121
Country	:	US
Telephone Number	:	856-858-9595
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MARK TIRONE
Credential	:	DPM
Telephone Number	:	856-858-9595

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	04/24/2008

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