Organization
MODERN PODIATRIC CARE P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C. NWAKANMA DPM (PHYSICAN)
(718) 465-3040
Entity
Organization
Contact information
Practice address
9204 SPRINGFIELD BLVD, QUEENS VILLAGE, NY 11428-1857
(718) 465-3040
Mailing address
11620 190TH ST, SAINT ALBANS, NY 11412-3132
(718) 465-3040
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
005629
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01984110
—
NY
Enumeration date
11/23/2007
Last updated
01/05/2009
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