Philadelphia Podiatry Group

Primary specialty

PodiatristTaxonomy code 213E00000X

License

SC002094L Issued in PA

Legal business name

PHILADELPHIA PODIATRY GROUP

Practice address

2428 S Broad St
Phila, PA 19145-4418

Phone

(215) 336-6600

NPI assigned

Dec 15, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alfred J Iezzi Jr., DPM

Title

President

Phone

(215) 336-6600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518029461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 S BROAD ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191454418",
            "telephone_number": "215-336-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 S BROAD ST",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191454418",
            "telephone_number": "215-336-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA PODIATRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "IEZZI",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-336-6600",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC002094L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE HMO",
            "identifier": "0687240000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phila Behavioral Health Services
• Phila Health Management Corp
• Philadelphia Ear, Nose & Throat Surgical Associates, PC
• Philadelphia Health Management Corp
• Philadelphia Health Management Corporation (PHMC) / Girlspace
• Philip C Stein DDS PC
• Kenyatta Kaream Phillips, B.S.
• Yaron Pickens, LMFT
• Donna Pietrafesa, PA
• Laverne R Pinckney, B.A.

• Podiatrist in Phila, PA
• Providers in Phila, PA by specialty
• Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.