Provider Demographics
NPI:1598047789
Name:FORWARD FOOTCARE PODIATRY, P.C.
Entity Type:Organization
Organization Name:FORWARD FOOTCARE PODIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:L
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-726-8880
Mailing Address - Street 1:3044 STEINWAY ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3802
Mailing Address - Country:US
Mailing Address - Phone:718-726-8880
Mailing Address - Fax:718-726-8887
Practice Address - Street 1:3044 STEINWAY ST
Practice Address - Street 2:2ND FL
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3802
Practice Address - Country:US
Practice Address - Phone:718-726-8880
Practice Address - Fax:718-726-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004956-1261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric