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General NPI Number Information
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NPI Number | 1609107523
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Entity Type | Organization
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Legal Business Name | MT KISCO PODIATRY ASSOCIATES PC
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Dates
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Enumeration Date | 01/15/2010
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Last Update Date | 09/30/2014
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Provider Practice Location Address
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Address Line | 344 E MAIN ST SUITE 206
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3027
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Country | US
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Telephone | 914-244-3338
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Fax | 914-244-1430
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Provider Business Mailing Address
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Address Line | 344 E MAIN ST SUITE 206
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City | MOUNT KISCO
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State | NY
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Zip | 10549-3027
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Country | US
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Telephone | 914-244-3338
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Fax | 914-244-1430
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Authorized Official
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Title or Position | DPM
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Name | AUDREY A ABATEMARCO
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Credential |
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Telephone | 914-244-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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