Provider Demographics
NPI:1861405235
Name:PINSKY, IRVING BRADLEY (DPM)
Entity type:Individual
Prefix:
First Name:IRVING
Middle Name:BRADLEY
Last Name:PINSKY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2519
Mailing Address - Country:US
Mailing Address - Phone:215-837-4928
Mailing Address - Fax:
Practice Address - Street 1:221E VILLAGE RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:18966-2519
Practice Address - Country:US
Practice Address - Phone:215-837-4928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004621L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0947340000OtherAMERIHEALTH/INDEPENDENCE
NJ126143Medicare PIN
PAU80856Medicare UPIN
PA038832Medicare PIN