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Contact Information

PORT WASHINGTON PODIATRY INC
1317 W GRAND AVENUE
PORT WASHINGTON PODIATRY
PORT WASHINGTON, WI53074
 Phone: 262-284-8800
 Fax: 262-284-8861
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for PORT WASHINGTON PODIATRY INC

NPI # 1013953926
LBN Legal business name PORT WASHINGTON PODIATRY INC
Authorized official JEFFREY BONGIORNO - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/20/2006
Last updated 04/20/2008 - About 18 years ago
Identifiers
WI License # 798025
WI Medicaid 43268200
Other DB0746 RR MCR
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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