Provider Demographics
NPI:1154533719
Name:SOKOLOWSKI, BERNARD D (DPM)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:D
Last Name:SOKOLOWSKI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WALTON AVE
Mailing Address - Street 2:DOCTORS OFFICE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2306
Mailing Address - Country:US
Mailing Address - Phone:718-402-1800
Mailing Address - Fax:718-402-2366
Practice Address - Street 1:825 WALTON AVE
Practice Address - Street 2:DOCTORS OFFICE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-2306
Practice Address - Country:US
Practice Address - Phone:718-402-1800
Practice Address - Fax:718-402-2366
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003989-1213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Not Answered213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY969966Medicaid
NYT51364Medicare UPIN
NY969966Medicaid