Provider Demographics
NPI:1487810743
Name:DFU MEDICAL PC
Entity type:Organization
Organization Name:DFU MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-964-9600
Mailing Address - Street 1:225 BROADWAY
Mailing Address - Street 2:ROOM 620
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3001
Mailing Address - Country:US
Mailing Address - Phone:212-964-9600
Mailing Address - Fax:212-964-1159
Practice Address - Street 1:225 BROADWAY
Practice Address - Street 2:ROOM 620
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3001
Practice Address - Country:US
Practice Address - Phone:212-964-9600
Practice Address - Fax:212-964-1159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty