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General NPI Number Information
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NPI Number | 1134465321
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Entity Type | Organization
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Legal Business Name | DOCTOR STEPHANIE FAMULARI PODIATRIST PC
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Dates
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Enumeration Date | 12/17/2012
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 1478 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3915
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Country | US
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Telephone | 718-737-8228
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Fax |
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Provider Business Mailing Address
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Address Line | 1478 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10301-3915
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Country | US
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Telephone | 718-737-8228
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF PODIATRIC MEDICINE
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Name | DR. STEPHANIE FAMULARI
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Credential | D.P.M
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Telephone | 718-737-8228
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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 |
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License Number State |
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