| NPI | 1710351242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EWA D'SILVA Dpm 718-720-8372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD0024540) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2022-11-23 |