Provider Demographics
NPI:1093710865
Name:GOEZ, EMILIO A (DPM)
Entity Type:Individual
Prefix:DR
First Name:EMILIO
Middle Name:A
Last Name:GOEZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:294 W MERRICK RD
Mailing Address - Street 2:STE 8
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3357
Mailing Address - Country:US
Mailing Address - Phone:516-378-8383
Mailing Address - Fax:516-377-6991
Practice Address - Street 1:294 W MERRICK RD
Practice Address - Street 2:STE 8
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3357
Practice Address - Country:US
Practice Address - Phone:516-378-8383
Practice Address - Fax:516-377-6991
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN004738213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP55621Medicare PIN
NYU33877Medicare UPIN
NY0873760001Medicare NSC