Organization · NPI-2

21st Century Footcare PC

Podiatrist, Foot & Ankle Surgery · Bay Shore, NY

NPI number1861564148
StatusActive
Last updated in NPPESJun 11, 2010

Details

NPI
1861564148
Entity type
Organization (NPI-2)
Legal business name
21st Century Footcare PC
Organization subpart
No
Enumeration date
Nov 14, 2006
Last updated
Jun 11, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
213ES0103X Podiatrist, Foot & Ankle SurgeryN0034811NYYes

Practice location

24 Brentwood Rd
Bay Shore, NY 11706-8011

Phone 631-666-8100

Mailing address

24 Brentwood Rd
Bay Shore, NY 11706-8011

Authorized official

Juliann Darin
Manager
6316668100

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, Foot & Ankle Surgery providers in Bay Shore, NY