GREEN MOUNTAIN FAMILY PODIATRY PC NPI 1407909039

NPI Information

NPI: 1407909039
Provider Name: GREEN MOUNTAIN FAMILY PODIATRY PC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
212 BROADWAY
WHITEHALL, NY
ZIP 12887
Phone: (518) 499-9264
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GREEN MOUNTAIN FAMILY PODIATRY PC is a foot and ankle surgery podiatrist in Whitehall, NY. GREEN MOUNTAIN FAMILY PODIATRY PC NPI is 1407909039. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

212 BROADWAY
WHITEHALL, NY
ZIP 12887-639
Phone: (518) 499-9264
Fax: (518) 499-9247

The provider's authorized official is Jose Guillermo Irizarry .
The authorized official title is Owner-president and has the following contact phone number (518) 499-9264.

The enumeration date for this NPI number is 1/18/2007 and was last updated on 6/21/2018.

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	213ES0103X	Podiatrist	Foot & Ankle Surgery	003568	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	59591	OTHER	NEW YORK	MVP HEALTH CARE
2	PAW48	OTHER	NEW YORK	EMPIRE BLUE CROSS
3	=========	OTHER	NEW YORK	THE EMPIRE PLAN
4	00810586	MEDICAID	NEW YORK
5	9659860-99	OTHER	NEW YORK	GHI
6	P3899	OTHER	NEW YORK	EMPIRE BLUE CROSS
7	041210000033	OTHER	NEW YORK	FIDELIS
8	1005566	OTHER	VERMONT	VERMONT MEDICAID
9	00028868	OTHER	VERMONT	BCBS VERMONT
10	000470542001	OTHER	NEW YORK	BLUESHIELD HEALTHNOW

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: 4/28/2024

NPI Synchronization or Removal

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