Provider Demographics
NPI:1316611270
Name:POCONO FOOT & ANKLE CONSULTANTS, P.C.
Entity type:Organization
Organization Name:POCONO FOOT & ANKLE CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAGGARD-LIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-517-7166
Mailing Address - Street 1:411 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-7566
Mailing Address - Country:US
Mailing Address - Phone:570-517-7716
Mailing Address - Fax:
Practice Address - Street 1:1605 N CEDAR CREST BLVD STE 609
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2351
Practice Address - Country:US
Practice Address - Phone:610-530-1440
Practice Address - Fax:610-530-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty