NPI 1013953926

Port Washington Podiatry INC

Organisation Podiatrist Port Washington, WI

Practice location

Address: 1317 W Grand Avenue Port Washington Podiatry, Port Washington, WI 53074
Phone: (262) 284-8800
Fax: (262) 284-8861
Mailing address: 2132 Willow Pond Way, Grafton, WI 53024-9102

Authorised official

Name: Jeffrey Joseph Bongiorno
Title: President
Phone: (262) 284-8800

Registered specialties

Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213E00000X Licence 798025 (WI)

Other Podiatrist providers in Wisconsin →

Registry record

NPI: 1013953926
Entity type: Organization
NPI issued: 20 Jun 2006
Record last updated: 20 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.