institution
Northport Podiatry Pc
Foot & Ankle Surgery Podiatrist in Northport, New York
NPI 1679745103

Northport Podiatry Pc is a Foot & Ankle Surgery Podiatrist based in Northport, NY and is specialized in Foot & Ankle Surgery. Northport Podiatry Pc practices in Northport, NY. The NPI Number for Northport Podiatry Pc is 1679745103 and holds a License No. N005219 (New York).

The current practice location address for Northport Podiatry Pc is 1032 Fort Salonga Rd, Northport, NY and can be reached out via phone at 631-754-3338 and via fax at 631-754-3367.

Location: 1032 Fort Salonga Rd, Northport, NY, 11768-2208
institution
Provider Profile Details
NPI Number
1679745103
Provider Name
Northport Podiatry Pc
Credential
Provider Entity Type
Organization
Address
1032 Fort Salonga Rd, Northport, NY, 11768-2208
Phone Number
631-754-3338
Fax Number
631-754-3367
Provider Enumeration Date
03/25/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
W3P441 01 NY MEDICARE PTAN
480034015 01 RR MEDICARE
01573528 05 NY
institution
Provider Business Practice Location Address Details
Address
1032 Fort Salonga Rd
City
State
Zip
11768-2208
Phone Number
631-754-3338
Fax Number
631-754-3367
person
Provider Business Mailing Address Details
Address
1032 Fort Salonga Rd
City
State
Zip
11768-2208
Phone Number
631-754-3338
Fax Number
631-754-3367
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
N005219 (New York)
Definition
Definition to come...
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