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General NPI Number Information
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NPI Number | 1811199326
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Entity Type | Organization
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Legal Business Name | ASTORIA ADVANCED FOOT CARE
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 501 5TH AVE RM 1108
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City | NEW YORK
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State | NY
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Zip | 10017-7880
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Country | US
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Telephone | 212-682-3338
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Fax | 212-682-3335
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Provider Business Mailing Address
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Address Line | 501 5TH AVE RM 1108
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City | NEW YORK
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State | NY
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Zip | 10017-7880
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Country | US
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Telephone | 212-682-3338
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Fax | 212-682-3335
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Authorized Official
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Title or Position | PODIATRIS
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Name | DR. ROGER ADAM HANS
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Credential |
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Telephone | 212-682-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | N004560
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License Number State | NY
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