Provider Demographics
NPI:1033219258
Name:NEW YORK PODIATRIC MEDICINE AND FOOT SPECIALISTS, LLP
Entity Type:Organization
Organization Name:NEW YORK PODIATRIC MEDICINE AND FOOT SPECIALISTS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.P.M.
Authorized Official - Prefix:
Authorized Official - First Name:DORENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOO-HOO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-274-9988
Mailing Address - Street 1:110 LAFAYETTE ST RM 603
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4116
Mailing Address - Country:US
Mailing Address - Phone:212-274-9988
Mailing Address - Fax:212-274-1172
Practice Address - Street 1:110 LAFAYETTE ST RM 603
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4116
Practice Address - Country:US
Practice Address - Phone:212-274-9988
Practice Address - Fax:212-274-1172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006013213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty