Organization
PODCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN TAJERSTEIN D.P.M. (PRESIDENT)
(718) 972-5000
Entity
Organization
Contact information
Practice address
2802 AVENUE P, BROOKLYN, NY 11229-1810
(718) 252-5590
(718) 972-3774
Mailing address
1335 54TH ST, BROOKLYN, NY 11219-4220
(718) 972-5000
(718) 972-3774
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01151000
—
NY
01
—
P5059-1
MEDICARE PROVIDER ID #
NY
Enumeration date
04/02/2009
Last updated
04/02/2009
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