=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023143039
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROCK G. POSITANO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2007
-----------------------------------------------------
Last Update Date | 07/30/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 519 EAST 72ND STREET SUITE 203A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10021-4028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-606-1858
-----------------------------------------------------
Fax | 212-774-2687
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 519 EAST 72ND STREET SUITE 203A
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10021-4028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-606-1858
-----------------------------------------------------
Fax | 212-774-2687
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF NON-SURGICAL FOOT/ANKLE
-----------------------------------------------------
Name | DR. ROCK G POSITANO
-----------------------------------------------------
Credential | DPM, MSC, MPH, FACR
-----------------------------------------------------
Telephone | 212-606-1858
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------