Provider Demographics
NPI:1982755187
Name:SOUND FOOT CARE PC
Entity Type:Organization
Organization Name:SOUND FOOT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:631-360-3344
Mailing Address - Street 1:49 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-1028
Mailing Address - Country:US
Mailing Address - Phone:631-360-3344
Mailing Address - Fax:631-724-8344
Practice Address - Street 1:49 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1028
Practice Address - Country:US
Practice Address - Phone:631-360-3344
Practice Address - Fax:631-724-8344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003650-1213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00800275Medicaid
NYPPW381Medicare ID - Type UnspecifiedGROUP NUMBER
NY6142900001Medicare NSC
NYP38931Medicare ID - Type UnspecifiedRONALD A. WASHINGTON
NY00800275Medicaid