Healthcare Provider Details

I. General information

NPI: 1083707491
Provider Name (Legal Business Name): JOSEPH R COMBA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 GRANNY RD
FARMINGVILLE NY
11738-2130
US

IV. Provider business mailing address

186 GRANNY RD
FARMINGVILLE NY
11738-2130
US

V. Phone/Fax

Practice location:
  • Phone: 631-736-4272
  • Fax: 631-716-0980
Mailing address:
  • Phone: 631-736-4272
  • Fax: 631-716-0980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN004469-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License NumberN004469-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberN004469-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberN004469-1
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberN004469-1
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN004469-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: