| NPI | 1659835569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INNJEA PARK Owner 917-920-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2023-02-02 |