Provider Demographics
NPI:1871123372
Name:LEPOER PODIATRY, INC.
Entity type:Organization
Organization Name:LEPOER PODIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KRYSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPOER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:401-453-2001
Mailing Address - Street 1:1 RANDALL SQ STE 408
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-7405
Mailing Address - Country:US
Mailing Address - Phone:401-453-2000
Mailing Address - Fax:401-453-2002
Practice Address - Street 1:1 RANDALL SQ STE 408
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-7405
Practice Address - Country:US
Practice Address - Phone:401-453-2000
Practice Address - Fax:401-453-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric