Provider Demographics
NPI:1518216985
Name:ROYAL FOOTCARE, PC
Entity Type:Organization
Organization Name:ROYAL FOOTCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LEOTAUD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-755-8077
Mailing Address - Street 1:1336 UTICA AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5912
Mailing Address - Country:US
Mailing Address - Phone:718-618-5551
Mailing Address - Fax:718-989-0260
Practice Address - Street 1:274 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-3432
Practice Address - Country:US
Practice Address - Phone:917-755-8077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006300213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty