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General NPI Number Information
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NPI Number | 1659410934
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Entity Type | Organization
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Legal Business Name | HUDSON PODIATRY ASSOCIATES, PC
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | 2050 SAW MILL RIVER RD
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-4108
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Country | US
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Telephone | 914-245-7888
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Fax | 914-245-7909
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Provider Business Mailing Address
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Address Line | 2050 SAW MILL RIVER RD
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-4108
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Country | US
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Telephone | 914-245-7888
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Fax | 914-245-7909
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WAYNE BLOOM
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Credential | DPM
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Telephone | 914-245-7888
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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 | N-004712
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | N-004707
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License Number State | NY
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