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General NPI Number Information
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NPI Number | 1255786331
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Entity Type | Organization
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Legal Business Name | PARK PLACE PODIATRY PLLC
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 291 BROADWAY STE 810
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City | NEW YORK
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State | NY
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Zip | 10007
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Country | US
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Telephone | 212-484-0922
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Fax |
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Provider Business Mailing Address
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Address Line | 291 BROADWAY STE 810
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City | NEW YORK
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State | NY
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Zip | 10007-1814
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Country | US
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Telephone | 212-484-0922
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAPHAEL LILKER
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Credential | DPM
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Telephone | 516-779-3654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 006450
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License Number State | NY
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