Healthcare Provider Details
I. General information
NPI: 1518054485
Provider Name (Legal Business Name): METRO FOOTCARE ASSOCIATES L.L.P.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2006
Last Update Date: 11/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2225 CLINTON AVE S
ROCHESTER NY
14618-2623
US
IV. Provider business mailing address
2225 CLINTON AVE S
ROCHESTER NY
14618-2623
US
V. Phone/Fax
- Phone: 585-473-5051
- Fax: 585-473-3033
- Phone: 585-473-5051
- Fax: 585-473-3033
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | N003613 |
| License Number State | NY |
VIII. Authorized Official
Name:
WENDY
MCCARTHY
Title or Position: OFFICE MANAGER
Credential:
Phone: 585-473-5051