Healthcare Provider Details
I. General information
NPI: 1467635516
Provider Name (Legal Business Name): RICHMOND HILL FAMILY FOOT CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/12/2007
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8641 LEFFERTS BLVD
RICHMOND HILL NY
11418-2508
US
IV. Provider business mailing address
8641 LEFFERTS BLVD
RICHMOND HILL NY
11418-2508
US
V. Phone/Fax
- Phone: 718-849-3338
- Fax: 718-849-3166
- Phone: 718-849-3338
- Fax: 718-849-3166
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | N003656 |
| License Number State | NY |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | N006146 |
| License Number State | NY |
VIII. Authorized Official
Name: DR.
NEMAAN
J
GHUMAN
Title or Position: PRESIDENT/OWNER
Credential: DPM
Phone: 718-849-3338