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Individual

DR. IMTIYAZ I KAPADWALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
220A SAINT NICHOLAS AVE, BROOKLYN, NY 11237-4807
(718) 418-8540
Mailing address
1309 HARBOR RD, HEWLETT, NY 11557-2640
(718) 418-8540

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
N005412
NY
213ES0131X
Foot Surgery Podiatrist
Primary
NOO5412
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01808488
NY
Enumeration date
01/26/2006
Last updated
03/07/2018
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