Provider Demographics
NPI:1710363403
Name:SAFE PODIATRIC CARE
Entity Type:Organization
Organization Name:SAFE PODIATRIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-200-0723
Mailing Address - Street 1:14825 88TH AVE APT #7E
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-3429
Mailing Address - Country:US
Mailing Address - Phone:347-458-6366
Mailing Address - Fax:
Practice Address - Street 1:14825 88TH AVE APT #7E
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3429
Practice Address - Country:US
Practice Address - Phone:347-458-6366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty