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Contact Information

SOUTHSIDE PODIATRY PC
903 E 82ND ST
BROOKLYN, NY11236
 Phone: 718-241-2000
 Fax: 718-241-5281
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for SOUTHSIDE PODIATRY PC · (Female)

NPI # 1205968799
Status Active
Credentials
Entity Individual
Enumeration date 03/10/2007
Last updated 07/19/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # N002003-1
  • NY License # N004686
  • NY Medicaid 01180363
  • NY Medicaid 01522036
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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