Provider Demographics
NPI:1437232816
Name:LONGWOOD FOOT CARE, P.C.
Entity Type:Organization
Organization Name:LONGWOOD FOOT CARE, P.C.
Other - Org Name:CHRISTINE STERN, DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:631-696-9636
Mailing Address - Street 1:100 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-4412
Mailing Address - Country:US
Mailing Address - Phone:631-696-9636
Mailing Address - Fax:631-696-9635
Practice Address - Street 1:100 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-4412
Practice Address - Country:US
Practice Address - Phone:631-696-9636
Practice Address - Fax:631-696-9635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-22
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004301213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5696290001Medicare NSC