| NPI | 1124292685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLENE WALTERS Office Administrator 718-337-6345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N002317) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N002317) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |