Provider Demographics
NPI:1588747893
Name:FIT FEET PODIATRY P.C.
Entity type:Organization
Organization Name:FIT FEET PODIATRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-332-8633
Mailing Address - Street 1:925 HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3052
Mailing Address - Country:US
Mailing Address - Phone:718-809-7511
Mailing Address - Fax:718-228-8444
Practice Address - Street 1:3111 BRIGHTON 2ND ST
Practice Address - Street 2:L2
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7535
Practice Address - Country:US
Practice Address - Phone:718-332-8633
Practice Address - Fax:718-332-0547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02128430Medicaid
NYU82796Medicare UPIN
NYPNW641Medicare ID - Type Unspecified