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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

NPI Number 1205968799
LBN Legal business name SOUTHSIDE PODIATRY PC
Authorized official MARK HUPART - (DPM/PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/10/2007
Last updated 07/19/2010 - About 16 years ago
Identifiers
NY License # N002003-1
NY License # N004686
NY Medicaid 01180363
NY Medicaid 01522036
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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