Provider Demographics
NPI:1184973190
Name:PHILIP L WHITMANDPMPC
Entity type:Organization
Organization Name:PHILIP L WHITMANDPMPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:WHITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:212-473-8529
Mailing Address - Street 1:65 FAYETTE RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7155
Mailing Address - Country:US
Mailing Address - Phone:212-473-8529
Mailing Address - Fax:212-473-9447
Practice Address - Street 1:220 E 63RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7660
Practice Address - Country:US
Practice Address - Phone:212-473-8529
Practice Address - Fax:212-473-9447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002629213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00403452Medicaid
NY00403452Medicaid