Healthcare Provider Details

I. General information

NPI: 1548507551
Provider Name (Legal Business Name): PHILIP MESSENGER DPM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2013
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 W END AVE
NEW YORK NY
10025-6918
US

IV. Provider business mailing address

697 W END AVE
NEW YORK NY
10025-6918
US

V. Phone/Fax

Practice location:
  • Phone: 212-724-7050
  • Fax: 212-501-0913
Mailing address:
  • Phone: 212-724-7050
  • Fax: 212-501-0913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. PHILIP MESSENGER
Title or Position: OWNER
Credential: DPM
Phone: 212-724-7050