| NPI | 1174072631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YELENA VORONOVA Member 718-554-3862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY N005994-1) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2020-02-06 |