Healthcare Provider Details

I. General information

NPI: 1811194137
Provider Name (Legal Business Name): DR. GERALD A. ESMOND, DPM,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 MAIN RD
RIVERHEAD NY
11901-1957
US

IV. Provider business mailing address

34 DAVIS RD
PORT WASHINGTON NY
11050-3907
US

V. Phone/Fax

Practice location:
  • Phone: 516-350-5400
  • Fax:
Mailing address:
  • Phone: 516-350-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberN005582
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberN005582
License Number StateNY

VIII. Authorized Official

Name: GERALD A ESMOND
Title or Position: OWNER
Credential: DPM
Phone: 516-350-5400