MEDICARE: TEJ PODIATRIC GROUP P.C

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	N004752-1	NY

General Provider Information

NPI Number	:	1275610982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEJ PODIATRIC GROUP P.C

Provider Business Mailing Address
First Line	:	33 W 125TH ST
Second Line	:	2ND FLOOR ROOM #5
City	:	NEW YORK
State	:	NY
Zip	:	10027-4512
Country	:	US
Telephone Number	:	212-369-7340
Fax Number	:	212-369-1071

Provider Business Practice Location Address
First Line	:	33 W 125TH ST
Second Line	:	2ND FLOOR ROOM #5
City	:	NEW YORK
State	:	NY
Zip	:	10027-4512
Country	:	US
Telephone Number	:	212-369-7340
Fax Number	:	212-369-1071

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. JIGNASA P JOSHI
Credential	:	DPM
Telephone Number	:	212-369-7340

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/14/2008

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