| Organization Name: | SUFFOLK PODIATRY PC |
| NPI Number: | 1790882983 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PETER CUTLER (PRESIDENT) |
| Mailing Address: | 111 Carleton Ave Suite 5 Islip Terrace |
| State: | NY US |
| Postal Code: | 117522236 |
| Phone Number: | 6315818822 |
| Fax Number: | 6315810857 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 05/04/2010 |
| 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: | |