MEDICARE: DR ROBERT T WOLTMAN DPM,PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	N005360	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073783270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR ROBERT T WOLTMAN DPM,PC

Provider Business Mailing Address
First Line	:	1488 METROPOLITAN AVE
Second Line	:	SUITE 3
City	:	BRONX
State	:	NY
Zip	:	10462-7446
Country	:	US
Telephone Number	:	718-823-6239
Fax Number	:

Provider Business Practice Location Address
First Line	:	1488 METROPOLITAN AVE
Second Line	:	SUITE 3
City	:	BRONX
State	:	NY
Zip	:	10462-7446
Country	:	US
Telephone Number	:	718-823-6239
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT T WOLTMAN
Credential	:	DPM
Telephone Number	:	718-823-6239

Provider Enumeration Date	:	03/04/2008
Last Update Date	:	10/03/2008

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