Organization
EAST PATCHOGUE PODIATRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD JAMES KORMYLO DPM (OWNER)
(631) 654-5566
Entity
Organization
Contact information
Practice address
285 SILLS RD, BLDG 5-6 #H, EAST PATCHOGUE, NY 11772-4869
(631) 654-5566
Mailing address
285 SILLS RD, BLDG 5-6 #H, EAST PATCHOGUE, NY 11772-4869
(631) 654-5566
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00588743
—
NY
Enumeration date
12/03/2007
Last updated
02/27/2020
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