RAPHA FOOT AND ANKLE CENTER (NPI# 1609045079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1609045079 |
Entity Type | Organization |
Organization Name | RAPHA FOOT AND ANKLE CENTER |
Practice Address |
4605 Frankford Ave Philadelphia PA 19124-5803 |
Mailing Address |
10 Liberte Ln Chesterbrook PA 19087-5721 |
Practice Telephone | 2152897007 |
Practice Fax Number | 2152893400 |
Mailing Telephone | 6105844143 |
Mailing Fax Number | 6105844143 |
Enumeration Date | 2008-02-29 |
Last Update Date | 2016-03-22 |
Authorized Official Name | DR. JONG MIN LEE (OWNER) |
Authorized Official Telephone | 2152897007 |
Authorized Official Credential | DPM |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
Podiatric Medicine & Surgery Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PA | 1009302350001 | 05 | |
PA | MEDICARE NAC (DME) | 5288640001 | 01 |
Street Address |
4605 FRANKFORD AVE |
City | PHILADELPHIA |
State | PA |
Zip Code | 19124-5803 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205915444 | Jong Min Lee | Podiatrist | 4605 Frankford Ave, Philadelphia, PA 19124-5803 | 2006-11-06 |
1629576350 | Rapha Foot and Ankle Center, Inc | Podiatrist | 4605 Frankford Ave, Philadelphia, PA 19124-5803 | 2018-01-29 |
1942477021 | Leslie Baeza | Podiatrist | 4605 Frankford Ave, Philadelphia, PA 19124-5803 | 2008-05-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831749308 | William Mark Hanna Sr. | Pharmacist | 4600 Rooselvelt Blvd Bldg G, Philadelphia, PA 19124 | 2019-09-17 |
1881256451 | Medical Discovery Systems, LLC | Durable Medical Equipment & Medical Supplies | 5425 Oxford Ave., 5425 Oxford Ave. Suite (3 A), Philadelphia, PA 19124 | 2019-07-03 |
1548731391 | Sierra Pinkney | Registered Nurse | 1615 Granite St, Philadelphia, PA 19124 | 2018-12-05 |
1922507987 | Xavier Sergio Henriquez | Counselor | 4510 Frankford Avenue 2nd Floor, Philadelphia, PA 19124 | 2018-02-06 |
1558881581 | Isabel Cristina Castillo Hernandez | Pediatrics | 4500-10, Apt 201b, Philadelphia, PA 19124 | 2017-06-21 |
1952843732 | Patrick Grugan | Social Worker | Roosevelt Boulevard & Adams Avenue, Philadelphia, PA 19124 | 2016-11-10 |
1811340482 | Katarzyna Liwski | Psychiatry & Neurology | 4641 Roosevelt Boulevard, E212, Drexel University College of Medicine Friends Hospital, Philadelphia, PA 19124 | 2016-07-19 |
1851769327 | Aleka Kostouros | Social Worker | Roosevelt Blvd & Adams Ave, Northeast Community Center for Behavioral Health, Philadelphia, PA 19124 | 2015-09-14 |
1407230378 | Sara Bachani | Psychiatry & Neurology | 4641 Roosevelt Blvd, Friends Hospital, Room 231, Philadelphia, PA 19124 | 2015-07-10 |
1215327051 | Alyssa Renee Kirk | Counselor | 4500-10 Frankford Ave, 2nd Floor, Philadelphia, PA 19124 | 2015-02-02 |
Find all providers in zip 19124 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326656208 | Delaney Wickramage | Podiatrist | 111 N 9th St Unit 203, Philadelphia, PA 19107-2449 | 2020-07-16 |
1659834604 | Anthony Errico | Podiatrist | 235 N Broad St Ste 3, Philadelphia, PA 19107-1531 | 2019-04-08 |
1508388794 | Farhad Foroudi | Podiatrist | 8835 Germantown Ave Ste 105a, Philadelphia, PA 19118-2718 | 2017-07-10 |
1720460884 | Muhaiminu Hossain | Podiatrist | 240 N Broad St, Philadelphia, PA 19102-1121 | 2015-06-25 |
1497161293 | Soyun Victoria Park | Podiatrist | 6628 Souder St, Philadelphia, PA 19149-2206 | 2014-07-01 |
1679988620 | Brett Thomas Williams | Podiatrist | 1934 Waverly St, C204, Philadelphia, PA 19146-1456 | 2014-06-29 |
1588007876 | Complete Foot & Ankle L.L.C. | Podiatrist | 2350 Tremont St, #410, Philadelphia, PA 19115-5030 | 2013-04-17 |
1457601494 | Maikel Griages | Podiatrist | 5555 Wissahickon Avenue, Apt. 216, Philadelphia, PA 19144 | 2012-09-18 |
1457606865 | David Portonova | Podiatrist | 235 North Broad Street, Philadelphia, PA 19102 | 2012-07-23 |
1649568056 | Nekeisha Alexander Abdul-hakim | Podiatrist | 6635 Chew Ave, Philadelphia, PA 19119 | 2011-07-19 |
Find all providers in PHILADELPHIA |
City | PHILADELPHIA |
Zip Code | 19124 |
Please comment or provide details below to improve the information on RAPHA FOOT AND ANKLE CENTER.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.