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General NPI Number Information
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NPI Number | 1073795407
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Entity Type | Organization
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Legal Business Name | BEST CARE PODIATRY, PLLC
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 804 MEACHAM AVE
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City | ELMONT
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State | NY
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Zip | 11003-4701
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Country | US
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Telephone | 516-599-2383
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Fax |
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Provider Business Mailing Address
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Address Line | 54 POLO RD
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City | MASSAPEQUA
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State | NY
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Zip | 11758-5941
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Country | US
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Telephone | 631-338-4329
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JEYCE DECLUE
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Credential | DPM
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Telephone | 631-338-4329
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N006075
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N006064
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License Number State | NY
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