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General NPI Number Information
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NPI Number | 1700023843
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Entity Type | Organization
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Legal Business Name | TRI STATE FOOT CARE, P.C
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Dates
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Enumeration Date | 01/12/2009
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Last Update Date | 04/22/2009
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Provider Practice Location Address
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Address Line | 13 S SHORE DR
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City | SOUTH AMBOY
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State | NJ
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Zip | 08879-3433
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Country | US
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Telephone | 866-464-1065
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Fax | 877-464-1065
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Provider Business Mailing Address
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Address Line | 9016 ROCKAWAY BEACH BLVD SUITE B
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1530
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Country | US
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Telephone | 866-464-1065
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Fax | 877-464-1065
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Authorized Official
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Title or Position | OWNER
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Name | DR. VASILIOS NICHOLAS SPYROPOULOS
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Credential | DPM
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Telephone | 86646411065
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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 | N005668
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License Number State | NY
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