Provider Demographics
NPI:1104913706
Name:OCEANSIDE PODIATRY
Entity type:Organization
Organization Name:OCEANSIDE PODIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-766-8500
Mailing Address - Street 1:2965 LONG BEACH RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3204
Mailing Address - Country:US
Mailing Address - Phone:516-766-8500
Mailing Address - Fax:516-766-8526
Practice Address - Street 1:2965 LONG BEACH RD
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3204
Practice Address - Country:US
Practice Address - Phone:516-766-8500
Practice Address - Fax:516-766-8526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01674799Medicaid
NY01172747Medicaid
NYT89839Medicare UPIN
NYCC9994Medicare PIN
NY4715060001Medicare NSC
NY01674799Medicaid
NYT81575Medicare UPIN