Healthcare Provider Details

I. General information

NPI: 1780647743
Provider Name (Legal Business Name): TERENCE MICHAEL MCELGUN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

Provider Other Name: TERENCE MICHAEL MCELGUN D.P.M.

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 FRANKLIN AVE SUITE 223
GARDEN CITY NY
11530-5801
US

IV. Provider business mailing address

520 FRANKLIN AVE SUITE 223
GARDEN CITY NY
11530-5801
US

V. Phone/Fax

Practice location:
  • Phone: 516-746-4732
  • Fax: 516-746-4947
Mailing address:
  • Phone: 516-746-4732
  • Fax: 516-746-4947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN004260
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: