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General NPI Number Information
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NPI Number | 1932912870
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Entity Type | Organization
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Legal Business Name | TLC 4 FEET PODIATRY SERVICES PC
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 2 EXECUTIVE PARK DR
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City | ALBANY
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State | NY
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Zip | 12203-3700
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Country | US
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Telephone | 518-419-3012
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Fax |
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Provider Business Mailing Address
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Address Line | 5 SAND CREEK RD STE 200
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City | ALBANY
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State | NY
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Zip | 12205-1400
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Country | US
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Telephone | 518-459-0711
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Fax | 518-275-0646
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Authorized Official
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Title or Position | DIRECTOR
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Name | THOMAS LAWRENCE CANDARA
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Credential | DPM
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Telephone | 518-459-0711
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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 |
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License Number State |
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