Provider Demographics
NPI:1326182478
Name:A.K. PODIATRIST D.P.M. P.C.
Entity type:Organization
Organization Name:A.K. PODIATRIST D.P.M. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEKS
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:917-476-0173
Mailing Address - Street 1:9 MURDOCK CT
Mailing Address - Street 2:APT 3-D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6449
Mailing Address - Country:US
Mailing Address - Phone:917-476-0173
Mailing Address - Fax:718-769-8087
Practice Address - Street 1:9 MURDOCK CT
Practice Address - Street 2:APT 3-D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6449
Practice Address - Country:US
Practice Address - Phone:917-476-0173
Practice Address - Fax:718-769-8087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006137213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02722085Medicaid
NY02722085Medicaid
NYV07735Medicare UPIN