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NPI Code Detail

MEDICARE: LIBERTY FOOTCARE,PLLC

MEDICARE: LIBERTY FOOTCARE,PLLC
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
1213ES0131XFoot Surgery PodiatristN005746NY

General Provider Information

NPI Number : 1932247038
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIBERTY FOOTCARE,PLLC
Provider Business Mailing Address
First Line : 12506 LIBERTY AVE
Second Line :
City : SOUTH RICHMOND HILL
State : NY
Zip : 11419-2234
Country : US
Telephone Number : 718-322-7209
Fax Number : 718-322-7210
Provider Business Practice Location Address
First Line : 12506 LIBERTY AVE
Second Line :
City : SOUTH RICHMOND HILL
State : NY
Zip : 11419-2234
Country : US
Telephone Number : 718-322-7209
Fax Number : 718-322-7210
Authorized Official
Title or Position : PARTNER
Name : DR. RUI DEMELO
Credential : DPM
Telephone Number : 718-322-7209
Provider Enumeration Date : 02/01/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

1770558397 — DR. SRINIVAS KESANAKURTHY M.D.
Practice Location Address:
12508 LIBERTY AVE
SOUTH RICHMOND HILL, NY
11419-2234
Practice Phone: 646-335-2795
Practice Fax:
1710040860 — DR. GEORGE VISHNUDATT JHAGROO SR. M.D
Practice Location Address:
12508 LIBERTY AVE , 12508 LIBERTY AVE
SOUTH RICHMOND HILL, NY
11419-2234
Practice Phone: 718-738-2614
Practice Fax:
1952449332 — LIBERTY FOOTCARE, PLLC
Practice Location Address:
12506 LIBERTY AVE
SOUTH RICHMOND HILL, NY
11419-2234
Practice Phone: 718-322-7209
Practice Fax: 718-322-7210
1720285174 — DR. SOPHIA MITA JAGROOP M. D
Practice Location Address:
125-08 LIBERTY AVENUE
RICHMOND HILL, NY
11419-2234
Practice Phone: 718-806-1434
Practice Fax: 718-806-1435
1497012314 — EMORY REHABILITATION SERVICE, INC.
Practice Location Address:
12506 LIBERTY AVE
SOUTH RICHMOND HILL, NY
11419-2234
Practice Phone: 718-848-3275
Practice Fax: 718-848-3929
1609381458 — INTERBORO HEART & VASCULAR PLLC
Practice Location Address:
12508 LIBERTY AVE
SOUTH RICHMOND HILL, NY
11419-2234
Practice Phone: 718-581-8093
Practice Fax:

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