MEDICARE: CENTRAL PARK PODIATRY PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist
2	213EP1101X	Primary Podiatric Medicine Podiatrist

General Provider Information

NPI Number	:	1740429703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL PARK PODIATRY PC

Provider Business Mailing Address
First Line	:	2172 CENTRAL PARK AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10710-1826
Country	:	US
Telephone Number	:	914-337-4900
Fax Number	:	914-337-5228

Provider Business Practice Location Address
First Line	:	2172 CENTRAL PARK AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10710-1826
Country	:	US
Telephone Number	:	914-337-4900
Fax Number	:	914-337-5228

Authorized Official
Title or Position	:	OWNER
Name	:	DR. OLGA SHVETS
Credential	:	DPM
Telephone Number	:	914-337-4900

Provider Enumeration Date	:	02/16/2009
Last Update Date	:	01/31/2024

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