| Organization Name: | PODI PRO PODIATRY |
| NPI Number: | 1033563994 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ARGIRIOS MANTZOUKAS (OWNER) |
| Mailing Address: | 2915 Astoria Blvd Astoria |
| State: | NY US |
| Postal Code: | 111021741 |
| Phone Number: | 7186069081 |
| Fax Number: | |
| NPI Enumeration Date: | 04/18/2016 |
| NPI Last Update Date: | 04/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 006060 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |