Healthcare Provider Details

I. General information

NPI: 1043146939
Provider Name (Legal Business Name): DGR PODIATRY SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4683 MERRICK RD
MASSAPEQUA NY
11758-6021
US

IV. Provider business mailing address

4683 MERRICK RD
MASSAPEQUA NY
11758-6021
US

V. Phone/Fax

Practice location:
  • Phone: 516-799-2525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID G ROBBINS
Title or Position: OWNER
Credential: DPM
Phone: 516-799-2525