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General NPI Number Information
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NPI Number | 1235467002
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Entity Type | Organization
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Legal Business Name | TOTAL PODIATRY CARE PC
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Dates
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Enumeration Date | 12/05/2009
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 4161 KISSENA BLVD
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City | FLUSHING
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State | NY
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Zip | 11355-3105
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Country | US
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Telephone | 516-998-8483
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Fax |
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Provider Business Mailing Address
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Address Line | 143 E 34TH ST APT 8S
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City | NEW YORK
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State | NY
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Zip | 10016-4725
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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 | PODIATRIST
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Name | DR. CHITRA REDDY
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Credential |
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Telephone | 516-998-8483
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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 | 006329
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License Number State | NY
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