MEDICARE: VYN PODIATRY 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	006017	NY

General Provider Information

NPI Number	:	1811911563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VYN PODIATRY PC

Provider Business Mailing Address
First Line	:	2306 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4917
Country	:	US
Telephone Number	:	718-769-8210
Fax Number	:	718-769-8087

Provider Business Practice Location Address
First Line	:	2306 AVENUE U
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4917
Country	:	US
Telephone Number	:	718-769-8210
Fax Number	:	718-769-8087

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. VADIM NEKRITIN
Credential	:	DPM
Telephone Number	:	718-769-8210

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	06/06/2008

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