Provider Demographics
NPI:1992704977
Name:KANE, TOM M (DPM)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:M
Last Name:KANE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 NORTHAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-1960
Mailing Address - Country:US
Mailing Address - Phone:412-492-7842
Mailing Address - Fax:
Practice Address - Street 1:8101 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5213
Practice Address - Country:US
Practice Address - Phone:412-367-3233
Practice Address - Fax:412-367-5733
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001532L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0005038230002Medicaid
PA0005038230002Medicaid
PAT28625Medicare UPIN