Provider Demographics
NPI:1912262924
Name:WESTPOD
Entity type:Organization
Organization Name:WESTPOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GRECO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-573-8440
Mailing Address - Street 1:13 MURRAY RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2609
Mailing Address - Country:US
Mailing Address - Phone:201-573-8440
Mailing Address - Fax:201-746-0455
Practice Address - Street 1:421 HUGUENOT ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7004
Practice Address - Country:US
Practice Address - Phone:914-632-5772
Practice Address - Fax:914-632-6760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003930261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric