=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497941108
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPANISH AMERICAN FOOT ASSOCIATES PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2007
-----------------------------------------------------
Last Update Date | 03/14/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3741 91ST ST
-----------------------------------------------------
City | JACKSON HEIGHTS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11372-7927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-779-3900
-----------------------------------------------------
Fax | 718-779-1514
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3741 91ST ST
-----------------------------------------------------
City | JACKSON HEIGHTS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11372-7927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-779-3900
-----------------------------------------------------
Fax | 718-779-1514
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JAMES J ANARELLA
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 718-779-3900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | N004050
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------