=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497620181
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BROOKLYN PODIATRY ASSOCIATES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/10/2025
-----------------------------------------------------
Last Update Date | 10/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 420 74TH ST
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11209-2602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-458-9604
-----------------------------------------------------
Fax | 718-836-9555
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 420 74TH ST
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11209-2602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-458-9604
-----------------------------------------------------
Fax | 718-836-9555
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. SALVATORE GAUDINO
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 347-458-9604
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------