| NPI | 1003324179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAMDOU ABOUSAMRA Owner/Podiatrist 646-421-9356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N006502-1) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2019-12-31 |