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General NPI Number Information
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NPI Number | 1043875669
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Entity Type | Individual
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Provider Name | JAMES A SMALL SR. DPM
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Gender | Male
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 12073 FLATLANDS AVE
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City | BROOKLYN
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State | NY
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Zip | 11207-8306
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Country | US
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Telephone | 718-650-7272
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Fax |
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Provider Business Mailing Address
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Address Line | 18706 ROME DR
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City | SAINT ALBANS
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State | NY
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Zip | 11412-2607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 007272
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License Number State | NY
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