Provider Demographics
NPI:1124267935
Name:PREMIER FOOT & ANKLE ASSOCIATES PC
Entity type:Organization
Organization Name:PREMIER FOOT & ANKLE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GUERIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-776-1178
Mailing Address - Street 1:69 GRANDVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1707
Mailing Address - Country:US
Mailing Address - Phone:917-776-1178
Mailing Address - Fax:610-750-6632
Practice Address - Street 1:320 ABINGTON DR
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1898
Practice Address - Country:US
Practice Address - Phone:610-670-2277
Practice Address - Fax:610-670-5246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005836213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty