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General NPI Number Information
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NPI Number | 1366731903
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Entity Type | Organization
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Legal Business Name | RICHARD S PINNOCK DPM PC
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 87-59 171 STREET
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone | 718-291-4111
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Fax | 718-291-5042
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Provider Business Mailing Address
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Address Line | 87-59 171 STREET
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City | JAMAICA
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State | NY
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Zip | 11432
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Country | US
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Telephone | 718-291-4111
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Fax | 718-291-5042
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD S PINNOCK
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Credential | DPM
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Telephone | 718-291-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | N004829
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License Number State | NY
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