Provider Demographics
NPI:1053343640
Name:A PODIATRIC CARE PC
Entity type:Organization
Organization Name:A PODIATRIC CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUVISH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-946-8586
Mailing Address - Street 1:2844 OCEAN PKWY STE 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7904
Mailing Address - Country:US
Mailing Address - Phone:718-946-8586
Mailing Address - Fax:718-697-7463
Practice Address - Street 1:2844 OCEAN PKWY STE 6
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7904
Practice Address - Country:US
Practice Address - Phone:718-946-8585
Practice Address - Fax:718-697-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006082213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02653827Medicaid
PBWC31Medicare PIN
NY02653827Medicaid
NYV03921Medicare UPIN