Provider Demographics
NPI:1790018059
Name:LA PUMA, VITO (DPM)
Entity Type:Individual
Prefix:DR
First Name:VITO
Middle Name:
Last Name:LA PUMA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9103 153RD AVENUE
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-1603
Mailing Address - Country:US
Mailing Address - Phone:718-757-9361
Mailing Address - Fax:786-524-1137
Practice Address - Street 1:111 JOHN ST STE 1450
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-3122
Practice Address - Country:US
Practice Address - Phone:212-791-5700
Practice Address - Fax:786-524-1137
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006338213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery