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General NPI Number Information
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NPI Number | 1932126026
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Entity Type | Organization
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Legal Business Name | ASTORIA FOOT CARE GROUP
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 3117 DITMARS BLVD
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City | ASTORIA
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State | NY
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Zip | 11105-2305
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Country | US
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Telephone | 718-274-4040
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Fax |
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Provider Business Mailing Address
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Address Line | 3117 DITMARS BLVD
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City | ASTORIA
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State | NY
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Zip | 11105-2305
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Country | US
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Telephone | 718-274-4040
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. STEVEN MERMELSTEIN
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Credential | DPM
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Telephone | 718-274-4040
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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