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General NPI Number Information
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NPI Number | 1942637152
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Entity Type | Organization
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Legal Business Name | METROPOLITAN PODIATRY ASSOCIATES PC
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 80-02 KEW GARDENS ROAD
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City | KEW GARDENS
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State | NY
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Zip | 11415
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Country | US
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Telephone | 718-896-4555
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Fax | 718-544-1365
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Provider Business Mailing Address
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Address Line | 80-02 KEW GARDENS ROAD
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City | KEW GARDENS
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State | NY
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Zip | 11415
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Country | US
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Telephone | 718-896-4555
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Fax | 718-544-1365
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Authorized Official
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Title or Position | DPM
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Name | DR. KELLY LUCAS
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Credential | DPM
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Telephone | 570-460-3340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213EP0504X
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Taxonomy Name | Public Medicine 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 | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 213ER0200X
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Taxonomy Name | Radiology Podiatrist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 213ES0000X
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Taxonomy Name | Sports Medicine Podiatrist
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License Number |
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License Number State |
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Taxonomy #5
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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 #6
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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Taxonomy #7
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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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