Provider Demographics
NPI:1366516700
Name:PERSONAL PODIATRY, P.C.
Entity type:Organization
Organization Name:PERSONAL PODIATRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:ORLANDO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-683-6177
Mailing Address - Street 1:111 N CENTRAL AVE
Mailing Address - Street 2:SUITE 231
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1903
Mailing Address - Country:US
Mailing Address - Phone:914-683-6177
Mailing Address - Fax:914-683-6442
Practice Address - Street 1:111 N CENTRAL AVE
Practice Address - Street 2:SUITE 231
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1903
Practice Address - Country:US
Practice Address - Phone:914-683-6177
Practice Address - Fax:914-683-6442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-18
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002546213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP0W551Medicare ID - Type UnspecifiedGROUP NUMBER
NY5099910001Medicare NSC