# ISLAND FOOT AND ANKLE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639804834
- **Authorized official:** VERENA BEUTEL DAVIS (BILLER)
- **Authorized official phone:** (608) 526-2768

## Contact information

- **Practice address:** 1399 FRANKLIN AVE STE 304, GARDEN CITY, NY 11530-1678
- **Practice address phone:** (631) 422-4450
- **Mailing address:** 1111 MONTAUK HWY STE 100, WEST ISLIP, NY 11795-4910
- **Mailing address phone:** (631) 422-4450

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2022
- **Last updated:** 07/21/2022