Healthcare Provider Details

I. General information

NPI: 1063928117
Provider Name (Legal Business Name): TOETAL PODIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2017
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 BROADWAY STE 1800
NEW YORK NY
10006
US

IV. Provider business mailing address

330 W 58TH ST APT 10J
NEW YORK NY
10019-1838
US

V. Phone/Fax

Practice location:
  • Phone: 800-369-3556
  • Fax:
Mailing address:
  • Phone: 917-945-7139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN006811-1
License Number StateNY

VIII. Authorized Official

Name: DR. YEKATERINA NARODETSKAYA
Title or Position: PRESIDENT
Credential: DPM
Phone: 917-945-7139