MEDICARE: FIT FEET PODIATRY 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	213ES0103X	Foot & Ankle Surgery Podiatrist

Other Identifiers

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

General Provider Information

NPI Number	:	1588747893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIT FEET PODIATRY P.C.

Provider Business Mailing Address
First Line	:	925 HAMPTON AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-3052
Country	:	US
Telephone Number	:	718-809-7511
Fax Number	:	718-228-8444

Provider Business Practice Location Address
First Line	:	3111 BRIGHTON 2ND ST
Second Line	:	L2
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7535
Country	:	US
Telephone Number	:	718-332-8633
Fax Number	:	718-332-0547

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEON STEPENSKY
Credential	:	DPM
Telephone Number	:	718-332-8633

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	03/18/2013

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