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General NPI Number Information
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NPI Number | 1003088238
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Entity Type | Organization
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Legal Business Name | QUEENS CORPORATE FOOT CARE, P.C.
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/15/2010
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Provider Practice Location Address
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Address Line | 221-10 JAMAICA AVE SUITE 104
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City | QUEENS VILLAGE
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State | NY
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Zip | 11428-2037
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Country | US
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Telephone | 718-776-7232
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Fax | 718-776-7418
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Provider Business Mailing Address
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Address Line | 221-10 JAMAICA AVE SUITE 104
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City | QUEENS VILLAGE
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State | NY
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Zip | 11428-2037
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Country | US
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Telephone | 718-776-7232
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Fax | 718-776-7418
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Authorized Official
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Title or Position | PODIATRIC SPECIALIST
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Name | DR. MELVIN B HURT
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Credential | DPM
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Telephone | 718-776-7232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | N005136
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License Number State | NY
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