Provider Demographics
NPI:1093907644
Name:DANIEL G HERBOWY
Entity Type:Organization
Organization Name:DANIEL G HERBOWY
Other - Org Name:FOOT DOCTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:HERBOWY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:315-866-3668
Mailing Address - Street 1:6 BUSINESS PARK CT
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-6309
Mailing Address - Country:US
Mailing Address - Phone:315-793-3668
Mailing Address - Fax:315-739-3691
Practice Address - Street 1:130 W ALBANY ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-1901
Practice Address - Country:US
Practice Address - Phone:315-866-3668
Practice Address - Fax:315-793-3691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1065540002Medicare NSC
NY50848AMedicare PIN