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General NPI Number Information
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NPI Number | 1982110334
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Entity Type | Organization
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Legal Business Name | VERA MALEZHIK, LLC
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Dates
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Enumeration Date | 12/21/2017
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Last Update Date | 12/21/2017
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Provider Practice Location Address
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Address Line | 115 BROADWAY STE 1800
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City | NEW YORK
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State | NY
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Zip | 10006-1604
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Country | US
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Telephone | 702-882-2454
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Fax |
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Provider Business Mailing Address
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Address Line | 800 PALISADE AVE APT 1202
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City | FORT LEE
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State | NJ
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Zip | 07024-4119
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Country | US
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Telephone | 702-882-2454
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. VERA MALEZHIK
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Credential | DPM
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Telephone | 170-288-2245
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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 | N006856
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License Number State | NY
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