Organization Name: | COMPREHENSIVE FOOT CARE PLLC |
NPI Number: | 1043332026 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | IAN KEITH COOK (PRESIDENT) |
Mailing Address: | 306 Nassau Rd Roosevelt |
State: | NY US |
Postal Code: | 115751342 |
Phone Number: | 5162233338 |
Fax Number: | 5162239349 |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 07/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 005172 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |