Provider Demographics
NPI:1588774418
Name:FAMILY FOOT CARE OF ROCHESTER PC
Entity type:Organization
Organization Name:FAMILY FOOT CARE OF ROCHESTER PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:585-244-1150
Mailing Address - Street 1:2101 LAC DEVILLE BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-244-1150
Mailing Address - Fax:585-473-9602
Practice Address - Street 1:2101 LAC DEVILLE BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-244-1150
Practice Address - Fax:585-473-9602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G0182222260OtherBLUE CHOICE
NY4490540001Medicare NSC
G0182222260OtherBLUE CHOICE
NY4490540002Medicare NSC
NYAA0122Medicare PIN