Provider Demographics
NPI:1639487093
Name:ABSOLUTE FOOT CARE PC
Entity type:Organization
Organization Name:ABSOLUTE FOOT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-292-0023
Mailing Address - Street 1:375 JAY ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3847
Mailing Address - Country:US
Mailing Address - Phone:718-875-9251
Mailing Address - Fax:718-246-5884
Practice Address - Street 1:375 JAY ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3847
Practice Address - Country:US
Practice Address - Phone:718-875-9251
Practice Address - Fax:718-246-5884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-20
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004355332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ100051848Medicare PIN
NY3895480001Medicare NSC
NYG100034535Medicare PIN
NYA100034997Medicare PIN