Provider Demographics
NPI:1245376342
Name:KATONAH PODIATRY, PC
Entity type:Organization
Organization Name:KATONAH PODIATRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-232-8880
Mailing Address - Street 1:200 KATONAH AVE
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2175
Mailing Address - Country:US
Mailing Address - Phone:914-232-8880
Mailing Address - Fax:914-232-2245
Practice Address - Street 1:200 KATONAH AVE
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2175
Practice Address - Country:US
Practice Address - Phone:914-232-8880
Practice Address - Fax:914-232-2245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003360-1213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00805821Medicaid
NY4181690001Medicare NSC
NYPKW211Medicare PIN
NY00805821Medicaid