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Organization
MA PODIATRY PLLC
Active
Organization
MA PODIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN EDWARD (CREDENTIALING SPECIALIST)
(646) 639-5291
Entity
Organization
Contact information
Practice address
970 N BROADWAY STE 206, YONKERS, NY 10701-1310
(646) 639-5291
(914) 664-2873
Mailing address
3950 60TH ST APT A35, WOODSIDE, NY 11377-3421
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
10/09/2020
Last updated
01/15/2021
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