Pedirite Medical Oh Llc | |
267 Broadway Fl 2 Brooklyn NY 11211-6216 | |
(212) 764-0008 | |
Not Available |
Full Name | Pedirite Medical Oh Llc |
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Speciality | General Practice |
Location | 267 Broadway Fl 2, Brooklyn, New York |
Authorized Official Name and Position | Solomon Klein (MEMBER) |
Authorized Official Contact | 2127640008 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pedirite Medical Oh Llc 267 Broadway Fl 2 Brooklyn NY 11211-6216 Ph: (212) 764-0008 | Pedirite Medical Oh Llc 267 Broadway Fl 2 Brooklyn NY 11211-6216 Ph: (212) 764-0008 |
NPI Number | 1902523624 |
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Provider Enumeration Date | 10/24/2022 |
Last Update Date | 10/24/2022 |
Medicare PECOS PAC ID | 4385011105 |
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Medicare Enrollment ID | O20221108003262 |
Identifier | Type | State | Issuer |
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1902523624 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Rudolph Mccomb |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1609095389 PECOS PAC ID: 0941362339 Enrollment ID: I20090320000098 |
Provider Name | Amy Jo Marcano-reik |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1982281929 PECOS PAC ID: 3577931245 Enrollment ID: I20221130002287 |
Provider Name | Rachel C Mazzola |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1366062093 PECOS PAC ID: 1355772070 Enrollment ID: I20230921002301 |
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