Provider Demographics
NPI:1861949372
Name:HARRISBURG FOOT AND ANKLE CENTER, INC.
Entity type:Organization
Organization Name:HARRISBURG FOOT AND ANKLE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:GROSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:717-651-0000
Mailing Address - Street 1:4033 LINGLESTOWN ROAD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17012-1153
Mailing Address - Country:US
Mailing Address - Phone:717-651-0000
Mailing Address - Fax:717-651-0001
Practice Address - Street 1:2025 TECHNOLOGY PKWY
Practice Address - Street 2:SUITE 201
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9400
Practice Address - Country:US
Practice Address - Phone:717-651-0000
Practice Address - Fax:717-651-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003731L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3895930001Medicare NSC
PA031437Medicare PIN