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Organization

NORTHEAST PODIATRY ASSOC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY J CUSACK DPM (PRESIDENT)
(631) 266-2220
Entity
Organization

Contact information

Practice address
1172 5TH AVE, EAST NORTHPORT, NY 11731-2631
(631) 266-2220
(631) 266-5119
Mailing address
1172 5TH AVE, EAST NORTHPORT, NY 11731-2631
(631) 266-2220
(631) 266-5119

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary

Other

Enumeration date
03/15/2007
Last updated
03/18/2008
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