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General NPI Number Information
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NPI Number | 1043332026
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE FOOT CARE PLLC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 306 NASSAU RD
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City | ROOSEVELT
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State | NY
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Zip | 11575-1342
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Country | US
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Telephone | 516-223-3338
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Fax | 516-223-9349
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Provider Business Mailing Address
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Address Line | 306 NASSAU RD
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City | ROOSEVELT
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State | NY
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Zip | 11575-1342
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Country | US
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Telephone | 516-223-3338
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Fax | 516-223-9349
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IAN KEITH COOK
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Credential | D.P.M.
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Telephone | 516-223-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 005172
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License Number State | NY
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