| NPI | 1497859664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD LEONARD DAMICO Podiatrist President 631-691-6060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N003837) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2014-04-25 |