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Organization

5TH AVENUE PODIATRY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BEN DIMICHINO D.P.M. (PRESIDENT)
(212) 768-7999
Entity
Organization

Contact information

Practice address
36 W 44TH ST, SUITE 401, NEW YORK, NY 10036-8102
(212) 768-7999
(212) 398-8356
Mailing address
36 W 44TH ST, SUITE 401, NEW YORK, NY 10036-8102
(212) 768-7999
(212) 398-8356

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004656
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0020595
GHI
01
2C2743
HEALTHNET
01
4450726
AETNA
01
792279003
UNITED HEALTHCARE
01
P1537389
OXFORD
01
P94591
EMPIRE BLUE CROSS BLUE SH
Enumeration date
12/20/2006
Last updated
04/02/2009
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