| NPI | 1821492018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON DAVID WAITE Owner 516-506-8839 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: UT 9114085-0501) |
| Enumeration Date | 2014-10-16 |
| Last Update Date | 2014-10-16 |