Provider Demographics
NPI:1255369724
Name:MC ALLISTER, KATY (DPM)
Entity type:Individual
Prefix:DR
First Name:KATY
Middle Name:
Last Name:MC ALLISTER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6902 AUSTIN ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4250
Mailing Address - Country:US
Mailing Address - Phone:718-793-6800
Mailing Address - Fax:718-947-1018
Practice Address - Street 1:6902 AUSTIN ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4250
Practice Address - Country:US
Practice Address - Phone:718-793-6800
Practice Address - Fax:718-947-1018
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006099213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02674853Medicaid
NYNO NUMBER FOR PODMedicaid
NYNO NUMBER FOR PODMedicaid
NYV05034Medicare UPIN
NY07086Medicare ID - Type Unspecified
P00397062Medicare PIN