Provider Demographics
NPI:1417798588
Name:TOTAL FOOT AND ANKLE CORP.
Entity type:Organization
Organization Name:TOTAL FOOT AND ANKLE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:REHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:929-460-6313
Mailing Address - Street 1:10 EMPIRE CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-6704
Mailing Address - Country:US
Mailing Address - Phone:929-460-6313
Mailing Address - Fax:
Practice Address - Street 1:26402 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1738
Practice Address - Country:US
Practice Address - Phone:929-460-6313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric