Provider Demographics
NPI:1891936993
Name:HEALTHY FEET NEW YORK
Entity Type:Organization
Organization Name:HEALTHY FEET NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-683-7757
Mailing Address - Street 1:40 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3467
Mailing Address - Country:US
Mailing Address - Phone:212-683-7757
Mailing Address - Fax:212-889-6150
Practice Address - Street 1:40 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3467
Practice Address - Country:US
Practice Address - Phone:212-683-7757
Practice Address - Fax:212-889-6150
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. JOHANNA YOUNER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-19
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004943213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU54477Medicare UPIN