Basic Information
| Provider Information | |||||||||
| NPI: | 1205912599 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MICHAEL TRITTO, DPM, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11801 ROCKVILLE PIKE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208522734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018816222 | ||||||||
| FaxNumber: | 3018811639 | ||||||||
| Practice Location | |||||||||
| Address1: | 11801 ROCKVILLE PIKE | ||||||||
| Address2: | SUITE 105 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208522734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3018816222 | ||||||||
| FaxNumber: | 3018811639 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2006 | ||||||||
| LastUpdateDate: | 03/13/2011 | ||||||||
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| AuthorizedOfficialLastName: | TRITTO | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/PODIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 3018816222 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.P.M. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | 01107 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.