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General NPI Number Information
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NPI Number | 1669626370
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Entity Type | Organization
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Legal Business Name | ADVANCED PODIATRY OF MANHASSET, PLLC
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Dates
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Enumeration Date | 11/07/2008
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 2110 NORTHERN BLVD STE 208
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City | MANHASSET
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State | NY
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Zip | 11030-3500
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Country | US
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Telephone | 516-869-3300
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Fax | 516-484-4229
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Provider Business Mailing Address
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Address Line | 2110 NORTHERN BLVD STE 208
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City | MANHASSET
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State | NY
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Zip | 11030-3500
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Country | US
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Telephone | 516-869-3300
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Fax | 516-484-4229
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Authorized Official
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Title or Position | OWNER
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Name | DR. PEDRAM A HENDIZADEH
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Credential | D.P.M.
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Telephone | 516-869-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 005950
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License Number State | NY
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