1427304971 NPI number — HAPPY & HEALTHY FEET PC

Table of content: (NPI 1427304971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427304971 NPI number — HAPPY & HEALTHY FEET PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAPPY & HEALTHY FEET PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427304971
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
57 HARRISON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAWORTH
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07641-1920
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-934-2211
Provider Business Mailing Address Fax Number:
718-934-2225

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
665 OCEAN PKWY
Provider Second Line Business Practice Location Address:
#2F
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11230-1195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-934-2211
Provider Business Practice Location Address Fax Number:
718-934-2225
Provider Enumeration Date:
08/01/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ISYANOVA
Authorized Official First Name:
ILVIRA
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
917-620-9187

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  006443 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A300070879 . This is a "MEDICARE DOWNSTATE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com