MEDICARE: ABSOLUTE FOOT CARE 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	332BC3200X	Customized Equipment (DME)	N004355	NY

General Provider Information

NPI Number	:	1639487093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABSOLUTE FOOT CARE PC

Provider Business Mailing Address
First Line	:	375 JAY ST
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11201-3847
Country	:	US
Telephone Number	:	718-875-9251
Fax Number	:	718-246-5884

Provider Business Practice Location Address
First Line	:	375 JAY ST
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11201-3847
Country	:	US
Telephone Number	:	718-875-9251
Fax Number	:	718-246-5884

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY R ROSENBLATT
Credential	:	DPM
Telephone Number	:	516-292-0023

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	10/31/2011

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