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NPI Code Detail

MEDICARE: DR. EDWARD LEONARD DAMICO DPM

MEDICARE: DR. EDWARD LEONARD DAMICO DPM
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
1213E00000XPodiatristN003837NY

Other Identifiers

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

General Provider Information

NPI Number : 1134113988
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD LEONARD DAMICO DPM
Provider Business Mailing Address
First Line : 1685 NEWBRIDGE RD
Second Line :
City : NORTH BELLMORE
State : NY
Zip : 11710-1603
Country : US
Telephone Number : 516-826-0103
Fax Number : 516-783-6657
Provider Business Practice Location Address
First Line : 1685 NEWBRIDGE RD
Second Line :
City : NORTH BELLMORE
State : NY
Zip : 11710-1603
Country : US
Telephone Number : 516-826-0103
Fax Number : 516-783-6657
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 11/19/2019

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