Provider Demographics
NPI:1780802264
Name:LONG ISLAND FOOT CARE, PC
Entity type:Organization
Organization Name:LONG ISLAND FOOT CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GOEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-378-8383
Mailing Address - Street 1:294 W MERRICK RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3374
Mailing Address - Country:US
Mailing Address - Phone:516-378-8383
Mailing Address - Fax:516-377-6991
Practice Address - Street 1:294 W MERRICK RD
Practice Address - Street 2:SUITE 8
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3374
Practice Address - Country:US
Practice Address - Phone:516-378-8383
Practice Address - Fax:516-377-6991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004890213E00000X
NYN004738213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty