Provider Demographics
NPI:1699915751
Name:ADVANCED FOOT CARE PLLC
Entity type:Organization
Organization Name:ADVANCED FOOT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-338-7700
Mailing Address - Street 1:1666 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3254
Mailing Address - Country:US
Mailing Address - Phone:718-338-7700
Mailing Address - Fax:718-338-7706
Practice Address - Street 1:1666 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3254
Practice Address - Country:US
Practice Address - Phone:718-338-7700
Practice Address - Fax:718-338-7706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005965-1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5589890001Medicare NSC