Healthcare Provider Details

I. General information

NPI: 1376605758
Provider Name (Legal Business Name): FAMILY FOOT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 04/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MAPLE LN S
VALATIE NY
12184-4827
US

IV. Provider business mailing address

6 MAPLE LN S
VALATIE NY
12184-4827
US

V. Phone/Fax

Practice location:
  • Phone: 518-758-1331
  • Fax: 518-758-1394
Mailing address:
  • Phone: 518-758-1331
  • Fax: 518-758-1394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DAVID B. PICCHIONE
Title or Position: MEMBER
Credential: DPM
Phone: 518-758-1331