Provider Demographics
NPI:1134173826
Name:ADVANCED FOOT CARE ASSOCIATES PLLC
Entity type:Organization
Organization Name:ADVANCED FOOT CARE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TUNG
Authorized Official - Middle Name:WOON
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-539-9001
Mailing Address - Street 1:13907 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3342
Mailing Address - Country:US
Mailing Address - Phone:718-539-9001
Mailing Address - Fax:718-539-9173
Practice Address - Street 1:13907 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3342
Practice Address - Country:US
Practice Address - Phone:718-539-9001
Practice Address - Fax:718-539-9173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06702Medicare ID - Type Unspecified