Provider Demographics
NPI:1194095141
Name:TOTAL CARE PODIATRY PC
Entity type:Organization
Organization Name:TOTAL CARE PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELDER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-723-1128
Mailing Address - Street 1:3514 MERMAID AVE
Mailing Address - Street 2:SUITE 004
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1508
Mailing Address - Country:US
Mailing Address - Phone:917-723-1128
Mailing Address - Fax:
Practice Address - Street 1:3514 MERMAID AVE
Practice Address - Street 2:SUITE 004
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1508
Practice Address - Country:US
Practice Address - Phone:917-723-1128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006244213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty