Provider Demographics
NPI:1538306840
Name:FLUSHING FOOT SPECIALISTS, LLC
Entity Type:Organization
Organization Name:FLUSHING FOOT SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER / MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-838-9873
Mailing Address - Street 1:13338 41ST RD
Mailing Address - Street 2:SUITE 2L
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3782
Mailing Address - Country:US
Mailing Address - Phone:917-838-9873
Mailing Address - Fax:
Practice Address - Street 1:13338 41ST RD
Practice Address - Street 2:SUITE 2L
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3782
Practice Address - Country:US
Practice Address - Phone:718-886-9086
Practice Address - Fax:718-886-2086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-08
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006109213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02703675Medicaid
NY6204090001Medicare NSC
NYG100000140Medicare PIN