Provider Demographics
NPI:1285885327
Name:ADVANCED PODIATRIC CARE P.C.
Entity type:Organization
Organization Name:ADVANCED PODIATRIC CARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:POLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAYDENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-601-9989
Mailing Address - Street 1:119 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:119 BELAIR RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3005
Practice Address - Country:US
Practice Address - Phone:917-601-9989
Practice Address - Fax:718-981-4632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006133213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty