# 5 BORO PODIATRY PC

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

## Provider details

- **NPI number:** 1912596271
- **Authorized official:** SADIA SHAH (OWNER)
- **Authorized official phone:** (917) 613-1629

## Contact information

- **Practice address:** 531 TARGEE ST, STATEN ISLAND, NY 10304-3501
- **Practice address phone:** (646) 837-5448
- **Practice address fax:** (718) 775-3150
- **Mailing address:** 1578 WILLIAMSBRIDGE RD APT 3A, BRONX, NY 10461-6268

## Taxonomy

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

## Other

- **Enumeration date:** 01/12/2021
- **Last updated:** 01/12/2021