| Portonova Foot And Ankle Specialists Llc | |
|
6850 Lows Rd Ste 316, Bloomsburg, PA 17815-8708 | |
| (570) 387-2202 | |
| (570) 387-2203 |
| Full Name | Portonova Foot And Ankle Specialists Llc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 6850 Lows Rd Ste 316, Bloomsburg, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750762043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | SC006404 (Pennsylvania) | Primary |
| Provider Name | David J Portonova |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457606865 PECOS PAC ID: 1951612613 Enrollment ID: I20150622001749 |
| Provider Name | Matthew C Kujat |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1801246640 PECOS PAC ID: 0143556761 Enrollment ID: I20190719001029 |
| Mailing Address | Practice Location Address |
|---|---|
| Portonova Foot And Ankle Specialists Llc Po Box 1935, Kingston, PA 18704-0935 Ph: (570) 288-8881 | Portonova Foot And Ankle Specialists Llc 6850 Lows Rd Ste 316, Bloomsburg, PA 17815-8708 Ph: (570) 387-2202 |
Karen Campbell, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 410 Glenn Ave, Suite 201, Bloomsburg, PA 17815 Phone: 570-387-2202 | |
Dr. David J. Portonova, D.P.M Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 6850 Lows Rd Ste 316, Bloomsburg, PA 17815 Phone: 570-387-2202 Fax: 570-387-2203 | |
Karen Campbell, Dpm Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 410 Glenn Ave, Suite 201, Bloomsburg, PA 17815 Phone: 570-387-2022 Fax: 570-387-2203 |