| Dr Stanley Idiculla, DPM | |
|
112 Elden St, Suite D, Herndon, VA 20170-4874 | |
| (703) 437-5353 | |
| Not Available |
| Full Name | Dr Stanley Idiculla |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 22 Years |
| Location | 112 Elden St, Herndon, Virginia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043274368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0131X | Podiatrist - Foot Surgery | XXXX (Virginia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Nova Foot And Ankle Pllc | 2860630613 | 4 |
| Provider Name | Nova Foot And Ankle Pllc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1770828527 PECOS PAC ID: 2860630613 Enrollment ID: O20150327000379 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Stanley Idiculla, DPM 112 Elden St, Suite D, Herndon, VA 20170-4874 Ph: (703) 437-5353 | Dr Stanley Idiculla, DPM 112 Elden St, Suite D, Herndon, VA 20170-4874 Ph: (703) 437-5353 |
Robert B. Bronfman Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 112 Elden Street, Suite D, Herndon, VA 20170 Phone: 703-437-5353 Fax: 703-437-6941 | |
Dr. Ami Parikh, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 112 Elden St, Suite D, Herndon, VA 20170 Phone: 703-437-5353 | |
Kevin Diep, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 112 Elden St Ste D, Herndon, VA 20170 Phone: 703-466-0802 Fax: 703-437-6941 | |
Nova Foot And Ankle Pllc Podiatrist Medicare: Medicare Enrolled Practice Location: 112 Elden St, Suite D, Herndon, VA 20170 Phone: 703-437-5353 |