| NPI | 1518416627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANN VINELLE CLARKE Owner 718-499-2498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NY 006461) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |