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General NPI Number Information
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NPI Number | 1750566329
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Entity Type | Organization
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Legal Business Name | 540 EAST 43RD STREET PODIATRY PLLC
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 540 E 43RD ST
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City | BROOKLYN
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State | NY
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Zip | 11203-5716
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Country | US
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Telephone | 718-451-1206
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Fax | 718-629-2427
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Provider Business Mailing Address
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Address Line | 540 E 43RD ST
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City | BROOKLYN
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State | NY
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Zip | 11203-5716
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Country | US
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Telephone | 718-451-1206
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Fax | 718-629-2427
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAUNA M LEWIS
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Credential | DPM
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Telephone | 718-451-1206
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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 | NOO5983
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License Number State | NY
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