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Organization

SPA PODIATRY, PC

Active
Other names
Malta Foot Specialists
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RUSSELL JOSEPH MONGIOVI DPM (SECRETARY/PARTNER)
(518) 899-3338
Entity
Organization

Contact information

Practice address
3 HEMPHILL PL STE 111, MALTA, NY 12020-4420
(518) 899-3338
Mailing address
3 HEMPHILL PL STE 111, MALTA, NY 12020-4420
(518) 899-3338
(518) 899-5025

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004782
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RB8170
RUSSELL J MONGIOVI, DPM
NY
01
RB8171
JOYCE M SENICK, DPM
NY
Enumeration date
03/26/2008
Last updated
05/18/2013
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