Individual
GLEDI PECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(801) 687-2493
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
007180
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2018
Last updated
11/29/2021
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