Provider Demographics
NPI:1154985737
Name:PODIATRY FAMILY FOOT CARE P.C.
Entity type:Organization
Organization Name:PODIATRY FAMILY FOOT CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDNIK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-899-8700
Mailing Address - Street 1:2610 OCEAN PKWY APT 5G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7751
Mailing Address - Country:US
Mailing Address - Phone:347-699-9433
Mailing Address - Fax:
Practice Address - Street 1:8710 37TH AVE STE B
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7748
Practice Address - Country:US
Practice Address - Phone:718-899-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty