Organization · NPI-2

5 Boro Podiatry PC

Podiatrist, Foot & Ankle Surgery · Staten Island, NY

NPI number1912596271
StatusActive
Last updated in NPPESJan 12, 2021

Details

NPI
1912596271
Entity type
Organization (NPI-2)
Legal business name
5 Boro Podiatry PC
Organization subpart
No
Enumeration date
Jan 12, 2021
Certification date
Jan 12, 2021
Last updated
Jan 12, 2021

Taxonomy and licenses

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

Practice location

531 Targee St
Staten Island, NY 10304-3501

Phone 646-837-5448 · Fax 718-775-3150

Mailing address

1578 Williamsbridge Rd Apt 3a
Bronx, NY 10461-6268

Authorized official

Sadia Shah
Owner
9176131629

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