| NPI | 1205280252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY VAN Podiatrist 718-844-1955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: NY 006604) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |