Organization
ELLIOT T UDELL DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIOT T UDELL DPM (DR.)
(516) 935-1113
Entity
Organization
Contact information
Practice address
120 BETHPAGE RD, SUITE 206, HICKSVILLE, NY 11801-1515
(516) 935-1113
Mailing address
120 BETHPAGE RD, SUITE 206, HICKSVILLE, NY 11801-1515
(516) 935-1113
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
002768
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WYTX31
MEDICARE PTAN
NY
Enumeration date
02/11/2008
Last updated
08/06/2008
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