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General NPI Number Information
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NPI Number | 1780802264
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Entity Type | Organization
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Legal Business Name | LONG ISLAND FOOT CARE, PC
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 294 W MERRICK RD SUITE 8
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City | FREEPORT
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State | NY
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Zip | 11520-3374
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Country | US
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Telephone | 516-378-8383
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Fax | 516-377-6991
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Provider Business Mailing Address
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Address Line | 294 W MERRICK RD SUITE 8
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City | FREEPORT
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State | NY
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Zip | 11520-3374
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Country | US
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Telephone | 516-378-8383
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Fax | 516-377-6991
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Authorized Official
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Title or Position | OWNER
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Name | DR. EMILIO GOEZ
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Credential | DPM
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Telephone | 516-378-8383
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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 | N004890
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N004738
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License Number State | NY
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