Healthcare Provider Details

I. General information

NPI: 1861143018
Provider Name (Legal Business Name): FULL FRAME PODIATRIC CARE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21616 UNION TPKE
FLUSHING NY
11364-3525
US

IV. Provider business mailing address

21616 UNION TPKE
FLUSHING NY
11364-3525
US

V. Phone/Fax

Practice location:
  • Phone: 718-465-4000
  • Fax: 718-624-7517
Mailing address:
  • Phone: 347-685-3196
  • Fax: 718-624-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: CAROL TONG
Title or Position: OWNER
Credential: DPM
Phone: 347-685-3196