Provider Demographics
NPI:1235207275
Name:FOOT & ANKLE PODIATRY ASSOCIATES, PC
Entity Type:Organization
Organization Name:FOOT & ANKLE PODIATRY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WEINFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-737-7474
Mailing Address - Street 1:1983 CROMPOND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-4121
Mailing Address - Country:US
Mailing Address - Phone:914-737-7474
Mailing Address - Fax:
Practice Address - Street 1:1983 CROMPOND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4121
Practice Address - Country:US
Practice Address - Phone:914-737-7474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005939213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU91108Medicare UPIN
NYPJ1111Medicare ID - Type Unspecified
NY4844160001Medicare NSC
NYU92148Medicare UPIN
NYPJ1331Medicare ID - Type Unspecified