Provider Demographics
NPI:1891984340
Name:DOWNTOWN PODIATRY INC
Entity type:Organization
Organization Name:DOWNTOWN PODIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHLONSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:216-252-1222
Mailing Address - Street 1:PO BOX 241310
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-8310
Mailing Address - Country:US
Mailing Address - Phone:216-252-1222
Mailing Address - Fax:216-252-2311
Practice Address - Street 1:18099 LORAIN AVE
Practice Address - Street 2:STE 420
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5610
Practice Address - Country:US
Practice Address - Phone:216-252-1222
Practice Address - Fax:216-252-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2107213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0496271Medicaid
OH9259353Medicare PIN
0885030001Medicare NSC
OH9259351Medicare PIN
OH480014302Medicare PIN
OH0885030001Medicare NSC
OHT80536Medicare PIN