Organization · NPI-2

5th Avenue Podiatry, PC

Podiatrist · New York, NY

NPI number1164586723
StatusActive
Last updated in NPPESApr 2, 2009

Details

NPI
1164586723
Entity type
Organization (NPI-2)
Legal business name
5th Avenue Podiatry, PC
Organization subpart
No
Enumeration date
Dec 20, 2006
Last updated
Apr 2, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213E00000X PodiatristN004656NYYes

Practice location

36 W 44th St
Suite 401
New York, NY 10036-8102

Phone 212-768-7999 · Fax 212-398-8356

Mailing address

36 W 44th St
Suite 401
New York, NY 10036-8102

Phone 212-768-7999 · Fax 212-398-8356

Authorized official

Ben Dimichino
President
2127687999

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