Provider Demographics
NPI:1851039770
Name:DR. DAWN OLSEN FIGLO, DPM, P.C.
Entity Type:Organization
Organization Name:DR. DAWN OLSEN FIGLO, DPM, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:OLSEN
Authorized Official - Last Name:FIGLO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-938-5766
Mailing Address - Street 1:60 LEWIS RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1619
Mailing Address - Country:US
Mailing Address - Phone:718-938-5766
Mailing Address - Fax:
Practice Address - Street 1:1432 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-4521
Practice Address - Country:US
Practice Address - Phone:646-289-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-20
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1346336948Medicaid