| NPI | 1245451525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE BLOOM President 914-245-7888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric (Licence: NY N004707) |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric (Licence: NY N004712) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-12-19 |