Organization Name: | BARAK PODIATRY,LLC |
NPI Number: | 1053574558 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH MICHAEL BARAK (PODIATRIST) |
Mailing Address: | 6715 Tippecanoe Rd Building D, Suite 100 Canfield |
State: | OH US |
Postal Code: | 444068180 |
Phone Number: | 3302860462 |
Fax Number: | 3302860436 |
NPI Enumeration Date: | 07/03/2008 |
NPI Last Update Date: | 03/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 003489 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |