| NPI | 1942910823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSCOE CHANG Podiatrist 929-266-6434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center, Podiatric |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2025-04-29 |