Provider Demographics
NPI:1467511154
Name:JOSEF GELDWERT DPM PC
Entity Type:Organization
Organization Name:JOSEF GELDWERT DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:GELDWERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-996-1900
Mailing Address - Street 1:111 E 88TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1111
Mailing Address - Country:US
Mailing Address - Phone:212-996-1900
Mailing Address - Fax:212-996-2110
Practice Address - Street 1:111 E 88TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1111
Practice Address - Country:US
Practice Address - Phone:212-996-1900
Practice Address - Fax:212-996-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYT50803213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00418002Medicaid
NYT50803Medicare UPIN
NYP28771Medicare PIN
NY6719650001Medicare NSC
NYA100000636Medicare PIN