Healthcare Provider Details

I. General information

NPI: 1447487228
Provider Name (Legal Business Name): TOMASZ ROSTKOWSKI, DPM P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 06/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 PICKWICK RD
MANHASSET NY
11030-3322
US

IV. Provider business mailing address

86 PICKWICK RD
MANHASSET NY
11030-3322
US

V. Phone/Fax

Practice location:
  • Phone: 516-967-1164
  • Fax: 516-706-0615
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005979-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. TOMASZ ROSTKOWSKI
Title or Position: DPM
Credential:
Phone: 516-967-1164