Provider Demographics
NPI:1437235017
Name:UNIVERSITY FOOT & ANKLE CENTER INC
Entity type:Organization
Organization Name:UNIVERSITY FOOT & ANKLE CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:PASCALIDES
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:401-861-8830
Mailing Address - Street 1:235 PLAIN STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-3240
Mailing Address - Country:US
Mailing Address - Phone:401-861-8830
Mailing Address - Fax:401-351-2378
Practice Address - Street 1:235 PLAIN STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3240
Practice Address - Country:US
Practice Address - Phone:401-861-8830
Practice Address - Fax:401-351-2378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0738000001Medicare NSC