Provider Demographics
NPI:1588679302
Name:ASSOCIATED FAMILY FOOT CARE CENTERS PLLC
Entity type:Organization
Organization Name:ASSOCIATED FAMILY FOOT CARE CENTERS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:NAGY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:603-964-6555
Mailing Address - Street 1:PO BOX 712
Mailing Address - Street 2:
Mailing Address - City:NORTH HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03862-0712
Mailing Address - Country:US
Mailing Address - Phone:603-964-6555
Mailing Address - Fax:603-964-6515
Practice Address - Street 1:875 GREENLAND RD UNIT C4
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4163
Practice Address - Country:US
Practice Address - Phone:603-964-6555
Practice Address - Fax:603-964-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH64882OtherHEALTHSOURCE
NHRE6900Medicare PIN
CK6507Medicare UPIN
NH4929480002Medicare NSC