Organization · NPI-2

Hernandez Podiatry P.C.

Podiatrist, Foot & Ankle Surgery · Bay Shore, NY

NPI number1174748677
StatusActive
Last updated in NPPESJul 9, 2008

Details

NPI
1174748677
Entity type
Organization (NPI-2)
Legal business name
Hernandez Podiatry P.C.
Organization subpart
No
Enumeration date
Apr 17, 2007
Last updated
Jul 9, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213ES0103X Podiatrist, Foot & Ankle Surgery––Yes

Practice location

85 W Main St
Suite 102
Bay Shore, NY 11706-8345

Phone 631-968-6300 · Fax 631-968-5886

Mailing address

85 W Main St
Suite 102
Bay Shore, NY 11706-8345

Phone 631-968-6300 · Fax 631-968-5886

Authorized official

William A Hernandez
Podiatrist
6319686300

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