Provider Demographics
NPI:1023595709
Name:FIVE TOWNS FOOT CARE LLP
Entity type:Organization
Organization Name:FIVE TOWNS FOOT CARE LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-295-4740
Mailing Address - Street 1:1100 PENINSULA BLVD
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1125
Mailing Address - Country:US
Mailing Address - Phone:516-295-4740
Mailing Address - Fax:516-295-2870
Practice Address - Street 1:1100 PENINSULA BLVD
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1125
Practice Address - Country:US
Practice Address - Phone:516-295-4740
Practice Address - Fax:516-295-2870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006902213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty