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General NPI Number Information
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NPI Number | 1104091859
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Entity Type | Organization
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Legal Business Name | C & GL PODIATRY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 07/04/2008
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Provider Practice Location Address
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Address Line | 1324 BERGEN ST
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City | BROOKLYN
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State | NY
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Zip | 11213-1530
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Country | US
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Telephone | 718-774-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 BERGEN ST
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City | BROOKLYN
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State | NY
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Zip | 11213-1530
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Country | US
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Telephone | 718-774-5224
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. JAIDEEP CHOPRA
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Credential | DPM
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Telephone | 718-774-5224
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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 | N005517
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License Number State | NY
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