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BRONX, NY
NPI1508178195
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy213ES0103X Podiatrist, Foot & Ankle Surgery
(Licence: NY  65006373)
Enumeration Date2010-07-12
Last Update Date2010-07-12
Business Address
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1430 DORIS ST APT 4 F
BRONX, NY 10462-4990
Phone number: 718-825-9900
Mailing Address
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1430 DORIS ST APT 4 F
BRONX, NY 10462-4990
Phone number: