Organization
JB PODIATRIC MEDICINE AND SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIA BONDARENKO DPM (PRESIDENT)
(917) 699-4139
Entity
Organization
Contact information
Practice address
1130 BRIGHTON BEACH AVE APT 1CC, BROOKLYN, NY 11235-5515
(718) 648-2707
(347) 462-2908
Mailing address
117 CHESTER AVE, STATEN ISLAND, NY 10312-5710
(917) 699-4139
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
N006041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02841734
—
NY
Enumeration date
04/20/2007
Last updated
05/01/2012
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