Provider Demographics
NPI:1225210057
Name:ALL ISLAND PODIATRY PC
Entity Type:Organization
Organization Name:ALL ISLAND PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:N
Authorized Official - Last Name:KESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-764-0434
Mailing Address - Street 1:200 N VILLAGE AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2341
Mailing Address - Country:US
Mailing Address - Phone:516-764-0434
Mailing Address - Fax:516-764-5643
Practice Address - Street 1:200 N VILLAGE AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2341
Practice Address - Country:US
Practice Address - Phone:516-764-0434
Practice Address - Fax:516-764-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2749213EP1101X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4684810001Medicare NSC