Provider Demographics
NPI:1215126081
Name:STERLING PODIATRY & MEDICAL OFFICE
Entity type:Organization
Organization Name:STERLING PODIATRY & MEDICAL OFFICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUTTERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-783-4780
Mailing Address - Street 1:737 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-4263
Mailing Address - Country:US
Mailing Address - Phone:718-783-4780
Mailing Address - Fax:718-778-6462
Practice Address - Street 1:737 NOSTRAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-4263
Practice Address - Country:US
Practice Address - Phone:718-783-4780
Practice Address - Fax:718-778-6462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYOO4186-1332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies