Provider Demographics
NPI:1801150461
Name:NEW YORK FOOT AND ANKLE PLLC
Entity type:Organization
Organization Name:NEW YORK FOOT AND ANKLE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:YAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:516-492-3155
Mailing Address - Street 1:261 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2146
Mailing Address - Country:US
Mailing Address - Phone:516-492-3155
Mailing Address - Fax:347-244-7149
Practice Address - Street 1:261 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2146
Practice Address - Country:US
Practice Address - Phone:516-492-3155
Practice Address - Fax:347-244-7149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-28
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003824-1213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG100077456Medicare UPIN