Provider Demographics
NPI:1801080213
Name:CIMAGLIA FOOT CARE PLLC
Entity type:Organization
Organization Name:CIMAGLIA FOOT CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CIMAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-533-2940
Mailing Address - Street 1:311 NORTH 4TH STREET, SUITE 4
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21550-1371
Mailing Address - Country:US
Mailing Address - Phone:301-533-2940
Mailing Address - Fax:301-533-2942
Practice Address - Street 1:311 NORTH 4TH STREET, SUITE 4
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1371
Practice Address - Country:US
Practice Address - Phone:301-533-2940
Practice Address - Fax:301-533-2942
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CIMAGLIA FOOT CARE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-29
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01261213E00000X
WV00337213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0100089000Medicaid
MD1255339511OtherINDIVIDUAL DR. NPI
MDKFT9, 61489306OtherBCBS OF MD
WV4760610003OtherNSC# DME MEDICARE- JURISDICTION C
MD1184747479OtherGROUP NPI FOR OAKLAND,MD
MD616600800Medicaid
MD7308039MD2OtherMAMSI, ALLIANCE
WV1801080213OtherGROUP NPI# FOR WEST VIRGINIA
MD1184747479OtherGROUP NPI FOR OAKLAND,MD
WVCI9337831, CI0856044Medicare PIN
MD4760610002Medicare PIN
MDKFT9, 61489306OtherBCBS OF MD
MD669M, 182FMedicare PIN
WV1801080213OtherGROUP NPI# FOR WEST VIRGINIA
MD1184747479OtherGROUP NPI FOR OAKLAND,MD
MD4760610002Medicare NSC