MEDICARE: JAMES MILIDANTRI DPM 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	213ES0103X	Foot & Ankle Surgery Podiatrist	N003866	NY

General Provider Information

NPI Number	:	1649508987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES MILIDANTRI DPM PC

Provider Business Mailing Address
First Line	:	111 JOHN ST
Second Line	:	SUITE 1450
City	:	NEW YORK
State	:	NY
Zip	:	10038-3101
Country	:	US
Telephone Number	:	212-791-5700
Fax Number	:	212-791-5704

Provider Business Practice Location Address
First Line	:	111 JOHN ST
Second Line	:	SUITE 1450
City	:	NEW YORK
State	:	NY
Zip	:	10038-3101
Country	:	US
Telephone Number	:	212-791-5700
Fax Number	:	212-791-5704

Authorized Official
Title or Position	:	PRES
Name	:	DR. JAMES MILIDANTRI
Credential	:	DPM
Telephone Number	:	212-791-5700

Provider Enumeration Date	:	11/25/2009
Last Update Date	:	11/25/2009

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