Provider Demographics
NPI:1538346564
Name:ASSOCIATED FOOT CARE PA
Entity type:Organization
Organization Name:ASSOCIATED FOOT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:207-783-4714
Mailing Address - Street 1:95 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5623
Mailing Address - Country:US
Mailing Address - Phone:207-783-4714
Mailing Address - Fax:
Practice Address - Street 1:95 EAST AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240
Practice Address - Country:US
Practice Address - Phone:207-783-4714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPOD193213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME480025851OtherRAILROAD MEDICARE
ME002527OtherANTHEM BC/BS
ME118360000Medicaid
ME1801992375OtherINDIVIDUAL NPI NUMBER
ME480025851OtherRAILROAD MEDICARE
MET31370Medicare UPIN
MEMM2256Medicare PIN
ME118360000Medicaid