Provider Demographics
NPI:1114714417
Name:FREDERICK FOOT AND ANKLE SPECIALISTS, P.C.
Entity type:Organization
Organization Name:FREDERICK FOOT AND ANKLE SPECIALISTS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YENISEY
Authorized Official - Middle Name:
Authorized Official - Last Name:YANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-668-9707
Mailing Address - Street 1:141 THOMAS JOHNSON DR STE 170
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4530
Mailing Address - Country:US
Mailing Address - Phone:301-668-9707
Mailing Address - Fax:
Practice Address - Street 1:19801 OBSERVATION DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-4070
Practice Address - Country:US
Practice Address - Phone:301-668-9707
Practice Address - Fax:301-668-4927
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FREDERICK FOOT AND ANKLE SPECIALISTS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-22
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric