Provider Demographics
NPI:1962694406
Name:ARTISAN PODIATRY, PC
Entity type:Organization
Organization Name:ARTISAN PODIATRY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:347-564-6661
Mailing Address - Street 1:320 7TH AVE
Mailing Address - Street 2:#135
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4113
Mailing Address - Country:US
Mailing Address - Phone:347-564-6661
Mailing Address - Fax:
Practice Address - Street 1:1435 86TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3403
Practice Address - Country:US
Practice Address - Phone:347-564-6661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty