Provider Demographics
NPI:1720384316
Name:PODIATRIC OR OF MIDTOWN MANHATTAN, P.C.
Entity Type:Organization
Organization Name:PODIATRIC OR OF MIDTOWN MANHATTAN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-262-4205
Mailing Address - Street 1:25 W 45TH ST
Mailing Address - Street 2:SUITE 1407
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-4902
Mailing Address - Country:US
Mailing Address - Phone:212-704-4310
Mailing Address - Fax:
Practice Address - Street 1:25 W 45TH ST
Practice Address - Street 2:SUITE 1407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4902
Practice Address - Country:US
Practice Address - Phone:212-704-4310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical