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Organization
COMPREHENSIVE PODIATRY ASSOCIATES DPM PC
Active
Organization
COMPREHENSIVE PODIATRY ASSOCIATES DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEN R DIMICHINO DPM (PRESIDENT)
(631) 689-0202
Entity
Organization
Contact information
Practice address
46 ROUTE 25A, STE 6, EAST SETAUKET, NY 11733
(631) 689-0202
(631) 689-2686
Mailing address
35 SHORE RD, EAST SETAUKET, NY 11733-3920
(631) 689-0202
(631) 689-2686
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01590385
—
NY
01
—
114212
VYTRA
—
01
—
1C1330
HEALTHNET
—
01
—
4450726
AETNA
—
01
—
792279
UNITED HEALTH CARE
—
01
—
AA47838
MDNY
—
01
—
P2545365
OXFORD
—
Enumeration date
08/31/2006
Last updated
04/09/2009
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