| NPI | 1235968447 |
|---|---|
| Former Legal Business Name | BRANDYWINE FOOT & ANKLE ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | TERESA LEONARDA CIACCIO Chief Operating Officer 516-993-8666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2024-07-29 |
| Last Update Date | 2024-07-29 |