Provider Demographics
NPI:1023190295
Name:DIABETIC FOOT CARE SERVICES, PC
Entity Type:Organization
Organization Name:DIABETIC FOOT CARE SERVICES, PC
Other - Org Name:PROHEALTH CARE ASSOCIATES, LLP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-591-3320
Mailing Address - Street 1:72-03 164TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4221
Mailing Address - Country:US
Mailing Address - Phone:718-591-3320
Mailing Address - Fax:718-591-4052
Practice Address - Street 1:72-03 164TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11365-4221
Practice Address - Country:US
Practice Address - Phone:718-591-3320
Practice Address - Fax:718-591-4052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PHW453Medicare PIN
NY4260670001Medicare NSC
P61732Medicare PIN
02500Medicare PIN