Provider Demographics
NPI:1801050406
Name:FOOT & ANKLE MEDICAL CARE PC
Entity type:Organization
Organization Name:FOOT & ANKLE MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:B
Authorized Official - Last Name:GALLINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-265-0255
Mailing Address - Street 1:343 W 58TH ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1108
Mailing Address - Country:US
Mailing Address - Phone:212-265-0255
Mailing Address - Fax:212-977-3732
Practice Address - Street 1:343 W 58TH ST
Practice Address - Street 2:SUITE 11
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1108
Practice Address - Country:US
Practice Address - Phone:212-265-0255
Practice Address - Fax:212-977-3732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-12
Last Update Date:2008-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty