| NPI | 1659182111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN L. RAY Chief Executive Officer 917-405-7881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2025-01-15 |
| Last Update Date | 2025-01-15 |