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General NPI Number Information
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NPI Number | 1295026524
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Entity Type | Organization
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Legal Business Name | NEW YORK CITY PODIATRY PLLC
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Dates
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Enumeration Date | 04/20/2011
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 136 E 57TH ST SUITE 801
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City | NEW YORK
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State | NY
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Zip | 10022-2707
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Country | US
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Telephone | 212-288-3137
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Fax | 646-688-2320
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Provider Business Mailing Address
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Address Line | 1665 E 7TH ST APT 3B
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City | BROOKLYN
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State | NY
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Zip | 11230-7068
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Country | US
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Telephone | 212-288-3137
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Fax | 646-688-2320
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ISAAC TABARI
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Credential | D.P.M.
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Telephone | 212-288-3137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 005693
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License Number State | NY
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