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General NPI Number Information
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NPI Number | 1477299410
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Entity Type | Organization
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Legal Business Name | ISLAND FOOT CARE CORP
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Dates
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Enumeration Date | 05/11/2022
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 1441 KAPIOLANI BLVD STE 608
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City | HONOLULU
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State | HI
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Zip | 96814-4403
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Country | US
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Telephone | 917-613-1629
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Fax |
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Provider Business Mailing Address
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Address Line | 1578 WILLIAMSBRIDGE RD APT 3A
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City | BRONX
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State | NY
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Zip | 10461-6268
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Country | US
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Telephone | 917-613-1629
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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. SADIA RIZVI SHAH
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Credential | MD
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Telephone | 917-613-1629
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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 |
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License Number State |
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