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NPI Code Detail

MEDICARE: DR. DOUGLAS LIVINGSTON D.P.M.

MEDICARE: DR. DOUGLAS LIVINGSTON D.P.M.
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
1213ES0103XFoot & Ankle Surgery PodiatristN005304-1NY

General Provider Information

NPI Number : 1558363002
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS LIVINGSTON D.P.M.
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 : 08/15/2005
Last Update Date : 12/30/2009

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