| Organization Name: | NORTHEAST WOUND |
| NPI Number: | 1699079905 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN S STARINSKI (PRESIDENT) |
| Mailing Address: | 215 South Robinson Avenue Pen Argyl |
| State: | PA US |
| Postal Code: | 180721946 |
| Phone Number: | 6108814025 |
| Fax Number: | 6108814066 |
| NPI Enumeration Date: | 12/29/2010 |
| NPI Last Update Date: | 03/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | SC002906L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |