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General NPI Number Information
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NPI Number | 1881966349
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Entity Type | Organization
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Legal Business Name | STABILE PODIATRY PC
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Dates
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Enumeration Date | 01/30/2012
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Last Update Date | 03/11/2012
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Provider Practice Location Address
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Address Line | 336 COMMACK RD UNIT 10
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City | DEER PARK
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State | NY
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Zip | 11729-5518
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Country | US
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Telephone | 516-606-6740
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Fax |
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Provider Business Mailing Address
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Address Line | 336 COMMACK RD UNIT 10
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City | DEER PARK
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State | NY
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Zip | 11729-5518
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Country | US
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Telephone | 516-606-6740
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT JOSEPH STABILE
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Credential | DPM
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Telephone | 516-606-6740
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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 | 006242
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License Number State | NY
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