Provider Demographics
NPI:1942543103
Name:COMPLETE PODIATRY SERVICES, P.C.
Entity Type:Organization
Organization Name:COMPLETE PODIATRY SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DORENE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOO-HOO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-274-9988
Mailing Address - Street 1:185 CANAL ST STE 206
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4537
Mailing Address - Country:US
Mailing Address - Phone:212-274-9988
Mailing Address - Fax:212-274-1172
Practice Address - Street 1:185 CANAL ST STE 206
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4537
Practice Address - Country:US
Practice Address - Phone:212-274-9988
Practice Address - Fax:212-274-1172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-05
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006013213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty