Provider Demographics
NPI:1801046040
Name:LARRIE S ROCKMACHER DPM PC
Entity Type:Organization
Organization Name:LARRIE S ROCKMACHER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROCKMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-244-0244
Mailing Address - Street 1:101 S BEDFORD RD STE 213
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3454
Mailing Address - Country:US
Mailing Address - Phone:914-244-0244
Mailing Address - Fax:914-244-0261
Practice Address - Street 1:101 S BEDFORD RD STE 213
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3454
Practice Address - Country:US
Practice Address - Phone:914-244-0244
Practice Address - Fax:914-244-0261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY65002177213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4256440001Medicare NSC
P21981Medicare PIN
T50677Medicare UPIN