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General NPI Number Information
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NPI Number | 1265730477
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Entity Type | Organization
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Legal Business Name | SENIOR FOOT CARE P.C.
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 76 S JEFFERSON AVE
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City | CATSKILL
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State | NY
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Zip | 12414-2108
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Country | US
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Telephone | 518-573-0946
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Fax |
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Provider Business Mailing Address
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Address Line | 76 S JEFFERSON AVE
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City | CATSKILL
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State | NY
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Zip | 12414-2108
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Country | US
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Telephone | 518-573-0946
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | MS. LISA M COLE
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Credential |
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Telephone | 518-424-3926
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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 | 002852
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License Number State | NY
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