| Organization Name: | MALTA FOOT SPECIALISTS |
| NPI Number: | 1346255825 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUSSELL JOSEPH MONGIOVI (SECRETARY) |
| Mailing Address: | 3 Hemphill Pl Ste 111 Ballston Spa |
| State: | NY US |
| Postal Code: | 120204420 |
| Phone Number: | 5188993338 |
| Fax Number: | 5188995025 |
| NPI Enumeration Date: | 07/31/2006 |
| NPI Last Update Date: | 04/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |