Organization Name: | PODIATRY SERVICES OF CENTRAL NEW YORK, PC |
NPI Number: | 1881075901 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FREDDIE L EDELMAN (OWNER) |
Mailing Address: | 206 Tuscorora Road Chittenango |
State: | NY US |
Postal Code: | 130370000 |
Phone Number: | 3156879400 |
Fax Number: | 3156879494 |
NPI Enumeration Date: | 06/15/2015 |
NPI Last Update Date: | 07/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | N002777-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |