Provider Demographics
NPI:1881850253
Name:PODIATRY ASSOCIATES OF NEW YORK
Entity Type:Organization
Organization Name:PODIATRY ASSOCIATES OF NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:GINSBURG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-981-0100
Mailing Address - Street 1:11 RALPH PL
Mailing Address - Street 2:SUITE 304
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4419
Mailing Address - Country:US
Mailing Address - Phone:718-981-0100
Mailing Address - Fax:718-981-0103
Practice Address - Street 1:11 RALPH PL
Practice Address - Street 2:SUITE 304
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4419
Practice Address - Country:US
Practice Address - Phone:718-981-0100
Practice Address - Fax:718-981-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005785-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty