Provider Demographics
NPI:1386289452
Name:GOOD ALIGN PODIATRY PLLC
Entity type:Organization
Organization Name:GOOD ALIGN PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIYONG
Authorized Official - Middle Name:
Authorized Official - Last Name:JEON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:213-254-7103
Mailing Address - Street 1:16 W 32ND ST STE 1001
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3852
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 W 32ND ST STE 1001
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3852
Practice Address - Country:US
Practice Address - Phone:646-891-0137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty