| Organization Name: | FOOTCARE ASSOCIATES OF REGO PARK PC |
| NPI Number: | 1063509537 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAUL BARRY BERNSTEIN (PRESIDENT) |
| Mailing Address: | 9424 63rd Dr Rego Park |
| State: | NY US |
| Postal Code: | 113742028 |
| Phone Number: | 7182680885 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 06/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | 0003536 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |