Provider Demographics
NPI:1063440147
Name:HOMMEL-HOCHSTEIN, BETH LISA (DPM)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:LISA
Last Name:HOMMEL-HOCHSTEIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BOND ST
Mailing Address - Street 2:GREAT NECK FAMILY FOOT CARE
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-2414
Mailing Address - Country:US
Mailing Address - Phone:516-482-5999
Mailing Address - Fax:
Practice Address - Street 1:7 BOND ST
Practice Address - Street 2:GREAT NECK FAMILY FOOT CARE
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2414
Practice Address - Country:US
Practice Address - Phone:516-482-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005512213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPA9371Medicare ID - Type Unspecified
NYU74425Medicare UPIN