| Organization Name: | BAYPORT PODIATRY ASSOCIATES, P.C. |
| NPI Number: | 1174674675 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANIEL E STERN (VICE PRESIDENT) |
| Mailing Address: | 671b Montauk Hwy Bayport |
| State: | NY US |
| Postal Code: | 117051607 |
| Phone Number: | 6314722112 |
| Fax Number: | 6314722605 |
| NPI Enumeration Date: | 01/13/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | N004302 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |