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General NPI Number Information
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NPI Number | 1467966515
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Entity Type | Organization
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Legal Business Name | PODIATRIC HEALTH P.C
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 2675 GRAND CONCOURSE
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City | BRONX
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State | NY
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Zip | 10468-3745
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Country | US
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Telephone | 347-323-1837
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Fax |
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Provider Business Mailing Address
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Address Line | 10524 67TH AVE APT 5B
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City | FOREST HILLS
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State | NY
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Zip | 11375-2181
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. IRINA ABRAMOVA
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Credential | DPM
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Telephone | 347-323-1837
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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 | N006812-1
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License Number State | NY
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