# POTOMAC PODIATRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** POTOMAC PODIATRY PLLC
- **Other names:** Crofton Podiatry
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1972171411
- **Legal business name:** POTOMAC PODIATRY PLLC
- **Authorized official:** VINCENT JOSEPH BONINI DPM (OWNER)
- **Authorized official phone:** (301) 200-3040

## Contact information

- **Practice address:** 1657 CROFTON BLVD STE 201, CROFTON, MD 21114-1352
- **Practice address phone:** (410) 721-4505
- **Mailing address:** 14010 SMOKETOWN RD STE 103, WOODBRIDGE, VA 22192-4723
- **Mailing address phone:** (703) 583-5959
- **Mailing address fax:** (703) 583-5995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 06/11/2021
- **Last updated:** 11/05/2021