Individual
DR. GEORGE DANIEL EMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
388 HAWKINS AVE, LAKE RONKONKOMA, NY 11779-4280
(631) 585-0045
(631) 585-7860
Mailing address
388 HAWKINS AVE, LAKE RONKONKOMA, NY 11779-4280
(631) 585-0045
(631) 585-7860
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N005709
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02216448
—
NY
01
—
130904
VYTRA
—
01
—
2154835
UNITED HEALTHCARE
—
01
—
P2654015
OXFORD
—
01
—
PG8341
BLUE CROSS
—
Enumeration date
11/01/2006
Last updated
09/04/2012
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