Port Washington Podiatry INC

NPI #1013953926 in Port Washington, Wisconsin

Provider Information

NPI Number: 1013953926
Entity Type: Organization
Organization Name: Port Washington Podiatry INC
Primary Specialty: Podiatrist
Enumeration Date: Jun 20, 2006
Last Updated: Apr 20, 2008

Practice Location

Address: 1317 W GRAND AVENUE
Address 2: PORT WASHINGTON PODIATRY
City: Port Washington
State: Wisconsin
ZIP Code: 53074
Phone: (262) 284-8800

Authorized Official

Name: JEFFREY JOSEPH BONGIORNO, DPM
Title: PRESIDENT
Phone: (262) 284-8800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist	213E00000X	Primary

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