Provider Demographics
NPI:1003394032
Name:MILLENNIUM PODIATRY, P.C.
Entity Type:Organization
Organization Name:MILLENNIUM PODIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARIN
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-539-0229
Mailing Address - Street 1:103 E 78TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0301
Mailing Address - Country:US
Mailing Address - Phone:212-535-0229
Mailing Address - Fax:
Practice Address - Street 1:103 E 78TH ST STE 103
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0301
Practice Address - Country:US
Practice Address - Phone:212-535-0229
Practice Address - Fax:212-452-1292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty