Basic Information
| Provider Information | |||||||||
| NPI: | 1225524341 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TURCIOS | ||||||||
| FirstName: | HENRY | ||||||||
| MiddleName: | SAMUEL | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 870 PATRICK HENRY DR | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 222051437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5714326087 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 5800 RIDGE AVENUE | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154839900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2018 | ||||||||
| LastUpdateDate: | 07/02/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213E00000X | SC006947 | PA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213ES0103X | SC006947 | PA | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.