Organization
LIFESTYLE PODIATRY, PC
Active
Other names
Foot Care of New York
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAITRAYA D THAKER DPM (PRESIDENT)
(770) 349-9861
Entity
Organization
Contact information
Practice address
2 W 45TH ST, SUITE 300, NEW YORK, NY 10036-4212
(770) 349-9861
Mailing address
1466 BLUFF CT, SUWANEE, GA 30024-3650
(770) 349-9861
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N004044
NY
Other
Enumeration date
07/25/2007
Last updated
12/26/2012
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