Provider Demographics
NPI:1376159756
Name:WEST SIDE FOOT GROUP, L.L.P.
Entity Type:Organization
Organization Name:WEST SIDE FOOT GROUP, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-543-1243
Mailing Address - Street 1:244 W 54TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-5597
Mailing Address - Country:US
Mailing Address - Phone:212-768-8666
Mailing Address - Fax:
Practice Address - Street 1:244 W 54TH ST FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5597
Practice Address - Country:US
Practice Address - Phone:212-768-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty