| NPI | 1053697219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW CICCONE Chief Operating Officer 845-561-7646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| 213ES0131X Podiatrist, Foot Surgery | |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2014-04-02 |