Organization
THE FOOT PERFORMANCE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID CARDILLO C.PED. (OWNER)
(585) 473-5950
Entity
Organization
Contact information
Practice address
3385 BRIGHTON HENRIETTA TOWN LINE RD, ROCHESTER, NY 14623-2813
(585) 473-5950
(585) 473-9596
Mailing address
3385 BRIGHTON HENRIETTA TOWN LINE RD, ROCHESTER, NY 14623-2813
(585) 473-5950
(585) 473-9596
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NY
335E00000X
Prosthetic/Orthotic Supplier
Primary
NOT REQUIRED
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02350998
—
NY
01
—
106985GD
PREFERRED CARE PROV ID
NY
01
—
1316013667
EXCELLUS
NY
Enumeration date
11/28/2006
Last updated
08/19/2013
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