Organization
MAIN ST FOOTCARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN D ROSENBLUM DPM (OWNER)
(718) 263-8118
Entity
Organization
Contact information
Practice address
820 LYDIG AVE, BRONX, NY 10462-2106
(718) 792-5900
(718) 931-9324
Mailing address
820 LYDIG AVE, BRONX, NY 10462-2106
(718) 792-5900
(718) 931-9324
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
N005978
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144492141
DMERC
NY
Enumeration date
03/31/2008
Last updated
04/03/2008
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