MODERN PODIATRIC CARE P.C NPI 1023299674

Podiatrist in Queens Village, NY

NPI 1023299674 Organization Podiatrist

About MODERN PODIATRIC CARE P.C

Modern Podiatric Care P.c is a provider established in Queens Village, New York specializing in podiatrist. The NPI number of Modern Podiatric Care P.c is 1023299674 and was assigned on November 2007. The practitioner's primary taxonomy code is 213E00000X with license number 005629 (NY). The provider is registered as an organization and their NPI record was last updated 12 years ago. Modern Podiatric Care P.c operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Michael C. Nwakanma Dpm (Physican)

A podiatrist like Modern Podiatric Care P.c provides medical and surgical care for people with foot, ankle, and lower leg issues. Podiatrists treat foot and ankle ailments like calluses, ingrown toenails, heel spurs, arthritis, congenital foot deformities, foot problems associated with diabetes and arch problems.

NPI

1023299674

Provider NameMODERN PODIATRIC CARE P.C
Provider Location Address9204 SPRINGFIELD BLVD QUEENS VILLAGE, NY 11428
Provider Mailing Address11620 190TH ST SAINT ALBANS, NY 11412
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date11-23-2007
Last Update Date01-05-2009


Primary Taxonomy

Taxonomy Code213E00000X
ClassificationPodiatrist
TypePodiatric Medicine & Surgery Service Providers
License No.005629
License StateNY
Taxonomy DescriptionA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Business Address

MODERN PODIATRIC CARE P.C
9204 SPRINGFIELD BLVD
QUEENS VILLAGE, NY
ZIP 11428
Phone: (718) 465-3040

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Mailing Address

MODERN PODIATRIC CARE P.C
11620 190TH ST
SAINT ALBANS, NY
ZIP 11412
Phone: (718) 465-3040



Authorized Official

Authorized Official Name MICHAEL C. NWAKANMA DPM
Authorized Official TitlePHYSICAN
Authorized Official Phone(718) 465-3040

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
PUW071MEDICARE PIN (08)NY
U76147MEDICARE UPIN (02)NY
01984110MEDICAID (05)NY
07583MEDICARE PIN (08)NY

Other Providers at the same location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1760579262DR. MICHAEL CHINEDU NWAKANMA DPM
Individual
Podiatrist9204 SPRINGFIELD BLVD
QUEENS VILLAGE, NY 11428
(718) 465-3040
1164614590QUEENS VILLAGE PRIMARY MEDICAL CARE, PLLC
Organization
Clinic/Center (Primary Care)9204 SPRINGFIELD BLVD
QUEENS VILLAGE, NY 11428
(718) 465-3040
1487206991 CANDACE NICOLEAU NP
Individual
Nurse Practitioner (Adult Health)9204 SPRINGFIELD BLVD
QUEENS VILLAGE, NY 11428
(718) 465-3040
1730708439 STEPHANIE LAI RDN, CDN
Individual
Dietitian, Registered9204 SPRINGFIELD BLVD
QUEENS VILLAGE, NY 11428
(718) 465-3040

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.