Provider Demographics
NPI:1336441864
Name:FUTURE PODIATRIST P.C.
Entity Type:Organization
Organization Name:FUTURE PODIATRIST P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:TSILOV
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:347-729-0615
Mailing Address - Street 1:2821 W 12TH ST APT 19D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3129
Mailing Address - Country:US
Mailing Address - Phone:347-729-0615
Mailing Address - Fax:347-729-0615
Practice Address - Street 1:2821 W 12TH ST APT 19D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3129
Practice Address - Country:US
Practice Address - Phone:347-729-0615
Practice Address - Fax:347-729-0615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-05
Last Update Date:2010-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006382213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty