Healthcare Provider Details

I. General information

NPI: 1518613025
Provider Name (Legal Business Name): PARKWAY PODIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2022
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 AVENUE P
BROOKLYN NY
11204-4934
US

IV. Provider business mailing address

248 AVENUE P
BROOKLYN NY
11204-4934
US

V. Phone/Fax

Practice location:
  • Phone: 718-236-5253
  • Fax: 718-331-6720
Mailing address:
  • Phone: 718-236-5253
  • Fax: 718-331-6720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ARIEL SONSTENG
Title or Position: OFFICE MANAGER
Credential:
Phone: 718-236-5253