Provider Demographics
NPI:1467851790
Name:STEP UP SURGICAL PODIATRY, PLLC
Entity Type:Organization
Organization Name:STEP UP SURGICAL PODIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NELYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOBKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-606-4065
Mailing Address - Street 1:2639 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2419
Mailing Address - Country:US
Mailing Address - Phone:718-753-9523
Mailing Address - Fax:
Practice Address - Street 1:291 BROADWAY RM 810
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1912
Practice Address - Country:US
Practice Address - Phone:212-606-4065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006527213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty