Provider Demographics
NPI:1740318773
Name:PODIATRY SERVICES OF NEW YORK PC
Entity type:Organization
Organization Name:PODIATRY SERVICES OF NEW YORK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLY
Authorized Official - Middle Name:STTETY
Authorized Official - Last Name:HONORE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-565-5666
Mailing Address - Street 1:6 CLARENDON RD
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-5315
Mailing Address - Country:US
Mailing Address - Phone:516-565-5666
Mailing Address - Fax:516-565-5665
Practice Address - Street 1:6 CLARENDON RD
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-5315
Practice Address - Country:US
Practice Address - Phone:516-565-5666
Practice Address - Fax:516-565-5665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005654213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000073671OtherGHI HMO
NY100202413001Medicaid
NY480031315OtherMEDICARE RAILROAD
NY100202413001OtherUNITED HEALTH CARE
NY2024130OtherUNITED HEALTH CARE
NY00932OtherHIP
NY114649OtherVYTRA HEALTH PLANS
NY2496744OtherAETNA HMO
NY7525222OtherAETNA POS
NY172884OtherELDERPLAN
NY2700932OtherUNITED HEALTH CARE
NY7525222OtherAETNA PPO
NY9677774OtherGHI
NYP2181026OtherOXFORD
NYPB849OtherEMPIRE BLUE SHIELD
NY02117944Medicaid
NYPB8491Medicare ID - Type Unspecified
NY114649OtherVYTRA HEALTH PLANS
NY2024130OtherUNITED HEALTH CARE
NY2496744OtherAETNA HMO