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General NPI Number Information
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NPI Number | 1285137430
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Entity Type | Organization
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Legal Business Name | MIDTOWN EAST PODIATRY AND FOOT SURGERY L.L.C.
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 230 E 48TH ST. #1B
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 212-679-3390
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Fax |
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Provider Business Mailing Address
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Address Line | 230 E 48TH ST. #1B
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 212-679-3390
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | AMY RESNIKOFF
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Credential |
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Telephone | 973-227-1860
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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 | N004688
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License Number State | NY
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