Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 36-00-2787M | OH |
N | 222Z00000X | Podiatrist | 36-00-2787M | OH |
Y | 213E00000X | Podiatrist | SC-003779R | PA |
Y | 222Z00000X | Podiatrist | SC-003779R | PA |
NPI | 1003888405 |
---|---|
Provider Name | Dr. Jeffrey Todd Molinaro |
First Address | Oakdale, PA 15071-1516 |
Second Address | Oakdale, PA 15071-1516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 30/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0887895 | MEDICARE ID (01) | OH |
0887896 | MEDICARE ID (01) | OH |
1184618639 | GROUP NPI (01) | OH |
1392756 | (05) | PA |
1699772822 | GROUP NPI (01) | OH |
U39577 | (02) |