Provider Demographics
NPI:1710929476
Name:WESTCHESTER PODIATRIC MEDICINE, P.C.
Entity Type:Organization
Organization Name:WESTCHESTER PODIATRIC MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARZANO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-423-0600
Mailing Address - Street 1:984 N BROADWAY,
Mailing Address - Street 2:SUITE LL03
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1308
Mailing Address - Country:US
Mailing Address - Phone:914-423-0600
Mailing Address - Fax:914-424-8338
Practice Address - Street 1:984 N BROADWAY,
Practice Address - Street 2:SUITE LL03
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1308
Practice Address - Country:US
Practice Address - Phone:914-423-0600
Practice Address - Fax:914-424-8338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY003773213E00000X
261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4541240002Medicare NSC
NYT51208Medicare UPIN
NYPNW771Medicare PIN
NY4541240001Medicare NSC