Healthcare Provider Details

I. General information

NPI: 1851126361
Provider Name (Legal Business Name): PODIATRY ON CALL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3709 FLATLANDS AVE
BROOKLYN NY
11234-3507
US

IV. Provider business mailing address

3709 FLATLANDS AVE
BROOKLYN NY
11234-3507
US

V. Phone/Fax

Practice location:
  • Phone: 718-957-3435
  • Fax:
Mailing address:
  • Phone: 718-444-7766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: PRAVIN RAJAKUMAR
Title or Position: OWNER
Credential: DPM
Phone: 646-331-0162