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General NPI Number Information
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NPI Number | 1538850649
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Entity Type | Organization
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Legal Business Name | WELLNESS PODIATRY PC
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Dates
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Enumeration Date | 05/18/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 495 S BROADWAY
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City | HICKSVILLE
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State | NY
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Zip | 11801-5040
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Country | US
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Telephone | 516-430-5971
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Fax |
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Provider Business Mailing Address
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Address Line | 3 SUTTON PL
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City | WHEATLEY HEIGHTS
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State | NY
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Zip | 11798-1526
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Country | US
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Telephone | 516-430-5971
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Fax |
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Authorized Official
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Title or Position | DPM
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Name | UZMA AZFAR
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Credential |
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Telephone | 516-430-5971
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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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