institution
South Shore Podiatry, Pllc
Foot Surgery Podiatrist in Massapequa, New York
NPI 1457735094

South Shore Podiatry, Pllc is a Foot Surgery Podiatrist based in Massapequa, NY and is specialized in Foot Surgery. South Shore Podiatry, Pllc practices in Massapequa, NY. The NPI Number for South Shore Podiatry, Pllc is 1457735094 and holds a License No. N006053-1 (New York).

The current practice location address for South Shore Podiatry, Pllc is 20 Hicksville Rd, Massapequa, NY and can be reached out via phone at 516-744-0354 and via fax at 855-959-1613.

Location: 20 Hicksville Rd, Massapequa, NY, 11758-5819
institution
Provider Profile Details
NPI Number
1457735094
Provider Name
South Shore Podiatry, Pllc
Credential
Provider Entity Type
Organization
Address
20 Hicksville Rd, Massapequa, NY, 11758-5819
Phone Number
516-744-0354
Fax Number
855-959-1613
Provider Enumeration Date
07/14/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
02669029 05 NY
A100127791 01 NY MEDICARE PTAN
PK6781 01 NY MEDICARE
institution
Provider Business Practice Location Address Details
Address
20 Hicksville Rd
City
State
Zip
11758-5819
Phone Number
516-744-0354
Fax Number
855-959-1613
person
Provider Business Mailing Address Details
Address
20 Hicksville Rd
City
State
Zip
11758-5819
Phone Number
516-744-0354
Fax Number
855-959-1613
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
License No.
N006053-1 (New York)
Definition
Definition to come...
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