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General NPI Number Information
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NPI Number | 1598906539
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Entity Type | Organization
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Legal Business Name | FOOT CARE OF CLIFTON PARK, PLLC
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Dates
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Enumeration Date | 03/22/2009
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 870 ROUTE 146
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3818
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Country | US
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Telephone | 518-371-7133
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Fax | 518-371-7135
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Provider Business Mailing Address
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Address Line | 870 ROUTE 146
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3818
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Country | US
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Telephone | 518-371-7133
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Fax | 518-371-7135
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Authorized Official
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Title or Position | MANAGER
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Name | DR. MINDY E. LAM
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Credential | D.P.M.
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Telephone | 518-371-7133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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