MEDICARE: NEW YORK FOOTCARE, PLLC

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	N006621-1	NY

General Provider Information

NPI Number	:	1366820391
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW YORK FOOTCARE, PLLC

Provider Business Mailing Address
First Line	:	3201 GRAND CONCOURSE APT 1N
Second Line	:	SUITE 1-N
City	:	BRONX
State	:	NY
Zip	:	10468-1226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 GRAND CONCOURSE APT 1N
Second Line	:	SUITE 1-N
City	:	BRONX
State	:	NY
Zip	:	10468-1226
Country	:	US
Telephone Number	:	718-365-6363
Fax Number	:

Authorized Official
Title or Position	:	PODIATRIST
Name	:	DR. MCELVIN POPE JR.
Credential	:
Telephone Number	:	917-328-9321

Provider Enumeration Date	:	05/11/2015
Last Update Date	:	05/11/2015

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