| Organization Name: | EASTSIDE PODIATRY |
| NPI Number: | 1023045549 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LEWIS G. GIGLIA (GENERAL PARTNER) |
| Mailing Address: | 430 Crosskeys Office Park Fairport |
| State: | NY US |
| Postal Code: | 14450 |
| Phone Number: | 5852231633 |
| Fax Number: | 5854218093 |
| NPI Enumeration Date: | 06/28/2006 |
| NPI Last Update Date: | 12/11/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | N003357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |