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General NPI Number Information
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NPI Number | 1447277280
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Entity Type | Organization
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Legal Business Name | NORTHTOWN PODIATRY GROUP PC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2121 MAIN ST SUITE 214
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City | BUFFALO
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State | NY
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Zip | 14214-2693
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Country | US
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Telephone | 716-838-2983
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Fax | 716-838-2942
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Provider Business Mailing Address
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Address Line | 2121 MAIN ST SUITE 214
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City | BUFFALO
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State | NY
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Zip | 14214-2693
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Country | US
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Telephone | 716-838-2983
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Fax | 716-838-2942
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Authorized Official
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Title or Position | PRESIDENT
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Name | SEAN E KEATING
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Credential | DPM
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Telephone | 716-838-2983
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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 |
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License Number State |
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