Healthcare Provider Details

I. General information

NPI: 1427035088
Provider Name (Legal Business Name): JOSEPH S FICCHI D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2005
Last Update Date: 06/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 NEW UTRECHT AVE
BROOKLYN NY
11204-5137
US

IV. Provider business mailing address

7301 NEW UTRECHT AVENUE
BROOKLYN NY
11204
US

V. Phone/Fax

Practice location:
  • Phone: 718-236-0213
  • Fax: 718-236-0217
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN004085-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: