Individual provider · NPI-1

Dr. Edward William Kolk, D.P.M.

Podiatrist · Bay Shore, NY

NPI number1497819247
StatusActive
Last updated in NPPESFeb 24, 2011

Details

NPI
1497819247
Entity type
Individual (NPI-1)
Name
Dr. Edward William Kolk
Credential
D.P.M.
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 19, 2006
Last updated
Feb 24, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213E00000X PodiatristN004109NYYes
163W00000X Registered Nurse309257NY

Practice location

39 New Hampshire Ave
Bay Shore, NY 11706-2507

Phone 631-273-4699 · Fax 631-273-4699

Mailing address

39 New Hampshire Ave
Bay Shore, NY 11706-2507

Phone 631-273-4699 · Fax 631-273-4699

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Podiatrist providers in Bay Shore, NY