| NPI | 1871083899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YELENA VORONOVA Member 718-554-3862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: NY N005994-1) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NY N005994-1) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2020-02-06 |