Provider Demographics
NPI:1073795407
Name:BEST CARE PODIATRY, PLLC
Entity Type:Organization
Organization Name:BEST CARE PODIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DECLUE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:631-338-4329
Mailing Address - Street 1:54 POLO RD
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-5941
Mailing Address - Country:US
Mailing Address - Phone:631-338-4329
Mailing Address - Fax:
Practice Address - Street 1:804 MEACHAM AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4701
Practice Address - Country:US
Practice Address - Phone:516-599-2383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006064213E00000X
NYN006075213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty