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General NPI Number Information
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NPI Number | 1629457718
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Entity Type | Organization
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Legal Business Name | OMS PODIATRY SERVICES PC
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Dates
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Enumeration Date | 05/22/2015
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 10030 DITMARS BLVD RM 325
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City | EAST ELMHURST
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State | NY
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Zip | 11369-1333
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Country | US
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Telephone | 718-393-7705
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Fax | 718-446-4547
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Provider Business Mailing Address
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Address Line | 6 OAK CREST DR
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City | HIGHLAND
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State | NY
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Zip | 12528-2708
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Country | US
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Telephone | 718-393-7705
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Fax | 718-446-4547
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Authorized Official
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Title or Position | DPM
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Name | KELVIN OGELLE
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Credential |
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Telephone | 718-399-7705
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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 | N005924
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License Number State | NY
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