Provider Demographics
NPI:1699799353
Name:GENTLE TOUCH PODIATRY, INC.
Entity type:Organization
Organization Name:GENTLE TOUCH PODIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-308-1654
Mailing Address - Street 1:2114 FOREST RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2913
Mailing Address - Country:US
Mailing Address - Phone:410-308-1654
Mailing Address - Fax:410-308-1657
Practice Address - Street 1:2114 FOREST RIDGE RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-2913
Practice Address - Country:US
Practice Address - Phone:410-308-1654
Practice Address - Fax:410-308-1657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD218388900Medicaid
MD218388900Medicaid
MD292PMedicare PIN
MDU02920Medicare UPIN