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General NPI Number Information
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NPI Number | 1902065485
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Entity Type | Organization
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Legal Business Name | NASSAU PODIATRIC SURGICAL OFFICES, PC
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 33 FRONT ST SUITE 306
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3601
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Country | US
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Telephone | 516-481-7414
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Fax | 516-481-5115
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Provider Business Mailing Address
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Address Line | 33 FRONT ST SUITE 306
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City | HEMPSTEAD
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State | NY
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Zip | 11550-3601
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Country | US
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Telephone | 516-481-7414
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Fax | 516-481-5115
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TODD ROTWEIN
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Credential | DPM
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Telephone | 516-481-7414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | N002821
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License Number State | NY
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