Provider Demographics
NPI:1457692311
Name:KINGS PLAZA FOOT CARE, PC
Entity Type:Organization
Organization Name:KINGS PLAZA FOOT CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:646-522-7556
Mailing Address - Street 1:2940 W 5TH ST APT 20B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3896
Mailing Address - Country:US
Mailing Address - Phone:646-522-7556
Mailing Address - Fax:
Practice Address - Street 1:5412 KINGS PLZ
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5217
Practice Address - Country:US
Practice Address - Phone:646-522-7556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004868261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric