| NPI | 1255757241 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADY PAULA DEJESUS Owner 347-820-2531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 006439) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 006439) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |