MEDICARE: NORTH SHORE PODIATRIC FOOT CARE CONSULTANT 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	213E00000X	Podiatrist	001958	NY

General Provider Information

NPI Number	:	1184870339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH SHORE PODIATRIC FOOT CARE CONSULTANT PC

Provider Business Mailing Address
First Line	:	3 BEACON HILL RD
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-3003
Country	:	US
Telephone Number	:	515-767-0673
Fax Number	:	516-767-3338

Provider Business Practice Location Address
First Line	:	3 BEACON HILL RD
Second Line	:
City	:	PORT WASHINGTON
State	:	NY
Zip	:	11050-3003
Country	:	US
Telephone Number	:	515-767-0673
Fax Number	:	516-767-3338

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. HIRAM CHIREL
Credential	:	DPM
Telephone Number	:	516-767-0673

Provider Enumeration Date	:	08/07/2008
Last Update Date	:	10/02/2008

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