Provider Demographics
NPI:1295165314
Name:ABBOTT FOOTCARE, PLLC
Entity type:Organization
Organization Name:ABBOTT FOOTCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MR
Authorized Official - First Name:ART
Authorized Official - Middle Name:
Authorized Official - Last Name:SALOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-289-2596
Mailing Address - Street 1:34 S BROADWAY
Mailing Address - Street 2:SUITE 504
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4400
Mailing Address - Country:US
Mailing Address - Phone:914-289-2596
Mailing Address - Fax:914-289-2591
Practice Address - Street 1:25 W 45TH ST
Practice Address - Street 2:SUITE1407
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4902
Practice Address - Country:US
Practice Address - Phone:212-704-4310
Practice Address - Fax:212-704-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty