Healthcare Provider Details

I. General information

NPI: 1104944321
Provider Name (Legal Business Name): PODIATRY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3630 HILL BLVD SUITE 104
JEFFERSON VALLEY NY
10535-1502
US

IV. Provider business mailing address

3630 HILL BLVD SUITE 104
JEFFERSON VALLEY NY
10535-1502
US

V. Phone/Fax

Practice location:
  • Phone: 914-962-5571
  • Fax: 914-962-5574
Mailing address:
  • Phone: 914-962-5571
  • Fax: 914-962-5574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberN003506
License Number StateNY

VIII. Authorized Official

Name: DR. ARNOLD LEWIS ISAACSON
Title or Position: PRESIDENT
Credential: D.P.M.
Phone: 914-962-5571