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General NPI Number Information
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NPI Number | 1255619821
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Entity Type | Organization
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Legal Business Name | VILLAGE FOOT CARE PC
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Dates
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Enumeration Date | 07/29/2011
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Last Update Date | 07/29/2011
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Provider Practice Location Address
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Address Line | 178 E 80TH ST 8-A
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City | NEW YORK
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State | NY
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Zip | 10075-0450
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Country | US
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Telephone | 914-632-2500
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Fax | 914-633-4358
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Provider Business Mailing Address
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Address Line | 178 E 80TH ST 8-A
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City | NEW YORK
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State | NY
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Zip | 10075-0450
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Country | US
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Telephone | 914-632-2500
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Fax | 914-633-4358
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. SCOTT L HAUSEN
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Credential | DPM
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Telephone | 914-632-2500
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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 | N004950
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License Number State | NY
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