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General NPI Number Information
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NPI Number | 1982660809
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Entity Type | Organization
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Legal Business Name | WESTSIDE PODIATRY CENTER LLP
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 02/09/2023
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Provider Practice Location Address
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Address Line | 8132B OSWEGO RD
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City | LIVERPOOL
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State | NY
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Zip | 13090-1500
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Country | US
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Telephone | 315-546-0285
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Fax | 315-546-0289
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Provider Business Mailing Address
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Address Line | 8132B OSWEGO RD
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City | LIVERPOOL
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State | NY
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Zip | 13090-1500
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Country | US
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Telephone | 315-546-0285
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Fax | 315-546-0289
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LYNDA MURA
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Credential |
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Telephone | 315-546-0285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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