Provider Demographics
NPI:1811065147
Name:BIRCH & BIRCH DPM
Entity type:Organization
Organization Name:BIRCH & BIRCH DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:BIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-447-1509
Mailing Address - Street 1:482 MANOR RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-2900
Mailing Address - Country:US
Mailing Address - Phone:718-447-1509
Mailing Address - Fax:718-447-7196
Practice Address - Street 1:482 MANOR RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-2900
Practice Address - Country:US
Practice Address - Phone:718-447-1509
Practice Address - Fax:718-447-7196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty