Organization Name: | ADIRONDACK FOOT CLINIC |
NPI Number: | 1043336191 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL C TRAN (PARTNER) |
Mailing Address: | 246 W Main St #5 Malone |
State: | NY US |
Postal Code: | 129531747 |
Phone Number: | 5184834284 |
Fax Number: | |
NPI Enumeration Date: | 03/21/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213EP1101X |
License Number: | 005763 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Primary Podiatric Medicine |
Taxonomy Definition: |