Provider Demographics
NPI:1346651486
Name:FOOT AND ANKLE ASSOCIATES LLP
Entity type:Organization
Organization Name:FOOT AND ANKLE ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:IANNUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-444-2114
Mailing Address - Street 1:PO BOX 825159
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-5159
Mailing Address - Country:US
Mailing Address - Phone:610-444-2114
Mailing Address - Fax:610-444-9571
Practice Address - Street 1:1 COMMERCE BLVD
Practice Address - Street 2:STE 102
Practice Address - City:WEST GROVE
Practice Address - State:PA
Practice Address - Zip Code:19390-9198
Practice Address - Country:US
Practice Address - Phone:610-345-0222
Practice Address - Fax:610-345-1148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
213E00000X, 213ES0103X
PA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0335570003Medicare NSC