Organization · NPI-2

1 Wise Podiatry Care P.C.

· Brooklyn, NY

NPI number1164442182
StatusActive
Last updated in NPPESFeb 6, 2020

Details

NPI
1164442182
Entity type
Organization (NPI-2)
Legal business name
1 Wise Podiatry Care P.C.
Organization subpart
No
Enumeration date
Jul 20, 2006
Certification date
Feb 6, 2020
Last updated
Feb 6, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213ES0131X N005994NYYes
261QP1100X Clinic/Center, Podiatric––

Practice location

3079 Brighton 13th St
Brooklyn, NY 11235-5607

Phone 718-554-3862 · Fax 718-554-0979

Mailing address

3079 Brighton 13th St
Brooklyn, NY 11235-5607

Phone 718-554-3862 · Fax 718-554-0979

Authorized official

Yelena Voronova
President
7185543862

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