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Organization
5TH AVENUE PODIATRY, PC
Active
Organization
5TH AVENUE PODIATRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEN DIMICHINO D.P.M. (PRESIDENT)
(212) 768-7999
Entity
Organization
Contact information
Practice address
36 W 44TH ST, SUITE 401, NEW YORK, NY 10036-8102
(212) 768-7999
(212) 398-8356
Mailing address
36 W 44TH ST, SUITE 401, NEW YORK, NY 10036-8102
(212) 768-7999
(212) 398-8356
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004656
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020595
GHI
—
01
—
2C2743
HEALTHNET
—
01
—
4450726
AETNA
—
01
—
792279003
UNITED HEALTHCARE
—
01
—
P1537389
OXFORD
—
01
—
P94591
EMPIRE BLUE CROSS BLUE SH
—
Enumeration date
12/20/2006
Last updated
04/02/2009
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