Provider Demographics
NPI:1548221708
Name:MAKOWER, BRYAN (DPM)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:MAKOWER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 2ND ST
Mailing Address - Street 2:635 SECOND STREET
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-2601
Mailing Address - Country:US
Mailing Address - Phone:718-282-6333
Mailing Address - Fax:718-756-0545
Practice Address - Street 1:443 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2821
Practice Address - Country:US
Practice Address - Phone:718-282-6333
Practice Address - Fax:718-756-0545
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003865213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP42871Medicare PIN
NYT51325Medicare UPIN