Organization
CORAM PODIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY CAMPBELL (CREDENTIALING MANAGER)
(239) 257-7290
Entity
Organization
Contact information
Practice address
100 MIDDLE COUNTRY RD, CORAM, NY 11727-4412
(631) 696-9636
Mailing address
100 MIDDLE COUNTRY RD, CORAM, NY 11727-4412
(631) 696-9636
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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