Provider Demographics
NPI:1225099476
Name:BROOKLYN PODIATRY PC
Entity Type:Organization
Organization Name:BROOKLYN PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-768-1906
Mailing Address - Street 1:635 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2601
Mailing Address - Country:US
Mailing Address - Phone:718-768-1906
Mailing Address - Fax:718-788-5192
Practice Address - Street 1:240 WILLOUGHBY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5465
Practice Address - Country:US
Practice Address - Phone:718-768-1906
Practice Address - Fax:718-788-5192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty