Organization
101ST AVENUE FOOT CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MICALLEF (PRESIDENT)
(718) 641-2100
Entity
Organization
Contact information
Practice address
10214 101ST AVE, OZONE PARK, NY 11416
(718) 641-2100
(718) 641-2101
Mailing address
10214 101ST AVE, OZONE PARK, NY 11416-2622
(718) 641-2100
(718) 641-2101
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00240G
GHI MEDICARE
NY
Enumeration date
09/16/2006
Last updated
08/23/2018
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