| Organization Name: | MOUNT KISCO PODIATRY ASSOCIATES, PC |
| NPI Number: | 1063748887 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RACHEL JUBAK (OFFICE MANAGER) |
| Mailing Address: | 101 S Bedford Rd Ste 214 Mount Kisco |
| State: | NY US |
| Postal Code: | 105493454 |
| Phone Number: | 9142443338 |
| Fax Number: | |
| NPI Enumeration Date: | 10/29/2009 |
| NPI Last Update Date: | 10/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 006195 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |