Provider Demographics
NPI:1689408429
Name:STEP BY STEP PODIATRY PLLC
Entity type:Organization
Organization Name:STEP BY STEP PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAROCCA HULSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:631-724-1166
Mailing Address - Street 1:260 E MIDDLE COUNTRY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2923
Mailing Address - Country:US
Mailing Address - Phone:631-724-1166
Mailing Address - Fax:631-724-4130
Practice Address - Street 1:260 E MIDDLE COUNTRY RD STE 104
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2923
Practice Address - Country:US
Practice Address - Phone:631-724-1166
Practice Address - Fax:631-724-4130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty