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General NPI Number Information
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NPI Number | 1588331748
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Entity Type | Organization
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Legal Business Name | BIPAD FOOTCARE CENTER LLC
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 08/25/2021
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Provider Practice Location Address
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Address Line | 16310 89TH AVE
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City | JAMAICA
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State | NY
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Zip | 11432-5006
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Country | US
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Telephone | 929-335-0400
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Fax | 929-564-9199
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Provider Business Mailing Address
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Address Line | 16310 89TH AVE
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City | JAMAICA
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State | NY
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Zip | 11432-5006
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Country | US
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Telephone | 929-335-0400
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Fax | 929-564-9199
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMED R BILLAH
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Credential | CPED
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Telephone | 646-775-5229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 224L00000X
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Taxonomy Name | Pedorthist
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License Number |
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License Number State |
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