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Organization
NORTHPORT PODIATRY PC
Active
Organization
NORTHPORT PODIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISE G RAIO D.P.M. (OWNER/PODIATRIST)
(631) 754-3338
Entity
Organization
Contact information
Practice address
1032 FORT SALONGA RD, NORTHPORT, NY 11768-2208
(631) 754-3338
(631) 754-3367
Mailing address
1032 FORT SALONGA RD, NORTHPORT, NY 11768-2208
(631) 754-3338
(631) 754-3367
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N005219
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01573528
—
NY
01
—
480034015
RR MEDICARE
—
01
—
W3P441
MEDICARE PTAN
NY
Enumeration date
03/25/2008
Last updated
02/24/2010
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