Provider Demographics
NPI:1871604926
Name:GANLEY PODIATRY ASSOCIATES PC
Entity type:Organization
Organization Name:GANLEY PODIATRY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:RUANE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-631-1994
Mailing Address - Street 1:104 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3029
Mailing Address - Country:US
Mailing Address - Phone:610-631-1994
Mailing Address - Fax:610-631-9383
Practice Address - Street 1:104 EGYPT RD
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-3029
Practice Address - Country:US
Practice Address - Phone:610-631-1994
Practice Address - Fax:610-631-9383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003413L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA=========OtherTAX ID NUMBER
PAU13992Medicare UPIN