Provider Demographics
NPI:1174918577
Name:HEALTHMARK FOOT AND ANKLE ASSOCIATES, P.C.
Entity type:Organization
Organization Name:HEALTHMARK FOOT AND ANKLE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ROMANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-565-3668
Mailing Address - Street 1:101 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3037
Mailing Address - Country:US
Mailing Address - Phone:610-565-3668
Mailing Address - Fax:610-565-9722
Practice Address - Street 1:790 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2547
Practice Address - Country:US
Practice Address - Phone:610-269-4610
Practice Address - Fax:610-269-4190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003145L335E00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0478810003Medicare NSC
PA0478810001Medicare NSC