John J Distazio in Homestead - Foot & Ankle Surgery
John J Distazio - NPI 1366414088
John J Distazio is a Foot & Ankle Surgery in Homestead, Pennsylvania. John J Distazio practices all healthcare services and medical treatments related to Foot & Ankle Surgery. The NPI Number for John J Distazio is 1366414088. The last update date is 2010-04-20.
John J Distazio's current location address is 495 Waterfront Dr E, Homestead, Pennsylvania. You can contact this provider via phone number 4124611108 and fax number 4124615490. The mailing address for John J Distazio is 495 Waterfront Dr E, Homestead, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John J Distazio |
|---|---|
| Address | 495 Waterfront Dr E, Homestead, Pennsylvania |
| Phone Number | 4124611108 |
| Fax Number | 4124615490 |
| Sole Proprietor | Y |
| Credentials | DPM |
NPI Number Detail
| NPI Number | 1366414088 |
|---|---|
| Provider Enumeration Date | 2006-02-06 |
| Last Updated Date | 2010-04-20 |
Provider Mailing Address Detail
| Address | 495 Waterfront Dr E |
|---|---|
| City | Homestead |
| State | Pennsylvania (PA) |
| Post Code | 151201140 |
| Phone Number | 4124611108 |
| Fax Number | 4124615490 |
Provider's Primary Taxonomy Detail
| Speciality | Foot & Ankle Surgery |
|---|---|
| Taxonomy | 213Es0103X |
| Licence No | SC002842L |
|
Definition: A doctor of podiatric medicine who diagnoses and treats disorders and injuries to the foot, ankle and related structures. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4134486 | PA | AETNA PIN | |
| 1156610001 | PA | DMERC PROV NUMBER | |
| 455619 | PA | HIGHMARK GRP PROV NUMBER | |
| 10941370001 | PA | -- | |
| 1009921 | PA | GATEWAY HMO NUMBER | |
| 1205011277 | PA | DMERC NPI NUMBER | |
| 1316123052 | PA | RR MEDICARE GROUP NPI | |
| 175132 | PA | HIGHMARK INDIVIDUAL PROV# | |
| 175132XXX | PA | MC GROUP PROV NUMBER | |
| 1316123052 | PA | MC GROUP NPI NUMBER |
Post Comment/ Review Below
What is the unique identification code assigned to John J Distazio by the Centers for Medicare & Medicaid Services?
The John J Distazio has been issued the NPI (National Provider Identifier) 1366414088. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where John J Distazio is located?
The John J Distazio is situated at the following address: 495 Waterfront Dr E, Homestead, PA, 151201140.
What is the John J Distazio's specialty and taxonomy code?
The John J Distazio's specialty is Foot & Ankle Surgery, and the corresponding taxonomy code is 213Es0103X.
On what date did the Centers for Medicare & Medicaid Services assign the 1366414088 to John J Distazio?
The Centers for Medicare & Medicaid Services assigned the 1366414088 to John J Distazio on 2006-02-06.
As of what date were the details pertaining to John J Distazio last refreshed?
The information related to the John J Distazio, including its address, specialty, and other relevant details, was last updated on 2010-04-20.
NPI Number: 1609879220
Address: 1910 Cherokee Ave. Sw, Cullman, AL