Provider Demographics
NPI:1205055019
Name:ASSOCIATED FOOT AND ANKLE SPECIALISTS, LLC
Entity type:Organization
Organization Name:ASSOCIATED FOOT AND ANKLE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSTIK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-816-8778
Mailing Address - Street 1:934 MANHATTAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-5915
Mailing Address - Country:US
Mailing Address - Phone:718-389-8585
Mailing Address - Fax:718-366-4830
Practice Address - Street 1:934 MANHATTAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-5915
Practice Address - Country:US
Practice Address - Phone:718-389-8585
Practice Address - Fax:718-366-4830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004973213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01716361Medicaid
NY01716361Medicaid
NYU32679Medicare UPIN