Organization
REGIONAL FOOT & ANKLE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELMO WILLIAM BALDASSARI JR. DPM (OWNER)
(570) 963-1974
Entity
Organization
Contact information
Practice address
1439 MONROE AVE STE 3, DUNMORE, PA 18509-2497
(570) 963-1974
(570) 963-0762
Mailing address
1439 MONROE AVE STE 3, DUNMORE, PA 18509-2497
(570) 963-1974
(570) 963-0762
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
SC003666L
PA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
SC-003666L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016528000002
—
PA
Enumeration date
03/25/2008
Last updated
04/10/2019
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