| Organization Name: | PODIATRY SERVICES PLLC |
| NPI Number: | 1699178962 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THERESA GIACOBBE (OFFICE MANAGER) |
| Mailing Address: | 175 Route 304 Bardonia |
| State: | NY US |
| Postal Code: | 109542042 |
| Phone Number: | 8452159800 |
| Fax Number: | 8452159803 |
| NPI Enumeration Date: | 10/01/2014 |
| NPI Last Update Date: | 10/01/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |