Provider Demographics
NPI:1932912870
Name:TLC 4 FEET PODIATRY SERVICES PC
Entity type:Organization
Organization Name:TLC 4 FEET PODIATRY SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:CANDARA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:518-459-0711
Mailing Address - Street 1:5 SAND CREEK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1400
Mailing Address - Country:US
Mailing Address - Phone:518-459-0711
Mailing Address - Fax:518-275-0646
Practice Address - Street 1:2 EXECUTIVE PARK DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-3700
Practice Address - Country:US
Practice Address - Phone:518-419-3012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty