EASY STRIDE PAIN & INJURY CENTER PC NPI 1366591596

NPI Information

NPI: 1366591596
Provider Name: EASY STRIDE PAIN & INJURY CENTER, PC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
4014 LANCASTER AVE # A
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 222-2225
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EASY STRIDE PAIN & INJURY CENTER, PC is a foot and ankle surgery podiatrist in Philadelphia, PA. EASY STRIDE PAIN & INJURY CENTER, PC NPI is 1366591596. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4014 LANCASTER AVE # A
PHILADELPHIA, PA
ZIP 19104-712
Phone: (215) 222-2225
Fax: (215) 222-3070

The provider's authorized official is J Gregory Bancroft .
The authorized official title is Podiatrist and has the following contact phone number (215) 222-2225.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	SC-001795-L	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0500527	MEDICAID	PENNSYLVANIA
2	1049959	OTHER	PENNSYLVANIA	KEYSTONE MERCY - EASY STR
3	1073543559	OTHER	PENNSYLVANIA	NPI INDIVIDUAL
4	31700	OTHER	PENNSYLVANIA	KEYSTONE MERCY INDIVIDUAL
5	0050052704	OTHER	PENNSYLVANIA	AMERICHOICE OF PA INDIVID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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