LONG ISLAND PODIATRY PC NPI 1063669430

NPI Information

NPI: 1063669430
Provider Name: LONG ISLAND PODIATRY PC
Classification: Podiatrist - 213EP1101X
Entity Type: Organization

Specialization: Primary Podiatric Medicine

Address:
56340 MAIN ROAD
SOUTHOLD, NY
ZIP 11725
Phone: (631) 765-2772
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LONG ISLAND PODIATRY PC is a primary podiatric medicine podiatrist in Southold, NY. LONG ISLAND PODIATRY PC NPI is 1063669430. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

56340 MAIN ROAD
SOUTHOLD, NY
ZIP 11725-805
Phone: (631) 765-2772

The provider's authorized official is Michael Lawrence Brody .
The authorized official title is President and has the following contact phone number (631) 549-3668.

The enumeration date for this NPI number is 8/27/2008 and was last updated on 4/10/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213EP1101X	Podiatrist	Primary Podiatric Medicine	N004211	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3902290001	MEDICARE NSC	NEW YORK
2	3902290001	MEDICARE PIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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