Provider Demographics
NPI:1629667175
Name:FIFTH PODIATRY LLC
Entity Type:Organization
Organization Name:FIFTH PODIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM
Authorized Official - Prefix:
Authorized Official - First Name:KARIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BADAWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-421-8563
Mailing Address - Street 1:551 CENTRAL AVE APT 21A
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2118
Mailing Address - Country:US
Mailing Address - Phone:516-569-3009
Mailing Address - Fax:
Practice Address - Street 1:551 CENTRAL AVE APT 21A
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2118
Practice Address - Country:US
Practice Address - Phone:516-569-3009
Practice Address - Fax:516-569-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty