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General NPI Number Information
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NPI Number | 1710379581
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Entity Type | Organization
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Legal Business Name | NEW YORK PODIATRY CARE PLLC
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 756 E PARK AVE
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City | LONG BEACH
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State | NY
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Zip | 11561-2605
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Country | US
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Telephone | 516-432-7470
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Fax |
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Provider Business Mailing Address
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Address Line | 756 E PARK AVE
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City | LONG BEACH
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State | NY
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Zip | 11561-2605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/ OWNER
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Name | SARAH KIM
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Credential | DPM
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Telephone | 206-694-3625
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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 | N006663-1
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License Number State | NY
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