Healthcare Provider Details

I. General information

NPI: 1346427473
Provider Name (Legal Business Name): GARY F STONES DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 BROADWAY
MASSAPEQUA NY
11758-5017
US

IV. Provider business mailing address

566 BROADWAY
MASSAPEQUA NY
11758-5017
US

V. Phone/Fax

Practice location:
  • Phone: 516-799-6616
  • Fax: 516-799-6472
Mailing address:
  • Phone: 516-799-6616
  • Fax: 516-799-6472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN0038101
License Number StateNY

VIII. Authorized Official

Name: GARY F STONES
Title or Position: OWNER
Credential: DPM
Phone: 516-799-6616