Provider Demographics
NPI:1386021616
Name:NJ FOOTCARE OF FLUSHING, P.C.
Entity Type:Organization
Organization Name:NJ FOOTCARE OF FLUSHING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOON
Authorized Official - Middle Name:S
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-939-9858
Mailing Address - Street 1:725 GRAND AVE STE 101102
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-1045
Mailing Address - Country:US
Mailing Address - Phone:718-939-9858
Mailing Address - Fax:718-939-9865
Practice Address - Street 1:725 GRAND AVE STE 101102
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-1045
Practice Address - Country:US
Practice Address - Phone:718-939-9858
Practice Address - Fax:718-939-9865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002497213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty