Provider Demographics
NPI:1598015216
Name:SACADA FOOT CARE PC.
Entity Type:Organization
Organization Name:SACADA FOOT CARE PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:DR
Authorized Official - First Name:ALMUTASEMB
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHEHADA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-986-0781
Mailing Address - Street 1:85 AVENUE O
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6542
Mailing Address - Country:US
Mailing Address - Phone:718-986-0781
Mailing Address - Fax:
Practice Address - Street 1:85 AVENUE O
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6542
Practice Address - Country:US
Practice Address - Phone:718-986-0781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006492261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric