Provider Demographics
NPI:1851333652
Name:BROOKLYN FOOT & ANKLE PC
Entity Type:Organization
Organization Name:BROOKLYN FOOT & ANKLE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOAVE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-780-5850
Mailing Address - Street 1:PO BOX 5455
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5455
Mailing Address - Country:US
Mailing Address - Phone:718-780-5850
Mailing Address - Fax:718-780-7260
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-5850
Practice Address - Fax:718-622-5104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4738410001Medicare NSC
NYPEW851Medicare PIN