MEDICARE: GERTSIK 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	213ES0131X	Foot Surgery Podiatrist	N005508	NY

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	:	1992745566
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERTSIK PODIATRY P.C.

Provider Business Mailing Address
First Line	:	415 OCEANVIEW AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235
Country	:	US
Telephone Number	:	718-934-4842
Fax Number	:	718-616-0165

Provider Business Practice Location Address
First Line	:	415 OCEANVIEW AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235
Country	:	US
Telephone Number	:	718-934-4842
Fax Number	:	718-616-0165

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VLADIMIR GERTSIK
Credential	:	DPM
Telephone Number	:	718-934-4842

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	10/01/2007

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