| Ny Foot & Ankle Specialist Dpm Pc | |
|
620 Suffolk Ave, Brentwood, NY 11717 | |
| (631) 231-1401 | |
| (631) 273-0125 |
| Full Name | Ny Foot & Ankle Specialist Dpm Pc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 620 Suffolk Ave, Brentwood, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851472419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | N005635 (New York) | Primary |
| Provider Name | Peter Mancuso |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1558339200 PECOS PAC ID: 6204820509 Enrollment ID: I20040410000118 |
| Provider Name | Robert Stuke |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1366947806 PECOS PAC ID: 1759625353 Enrollment ID: I20210720000127 |
| Provider Name | Kevin Kyuwan Shim |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1184116584 PECOS PAC ID: 8224441191 Enrollment ID: I20230710002361 |
| Mailing Address | Practice Location Address |
|---|---|
| Ny Foot & Ankle Specialist Dpm Pc 620 Suffolk Ave, Brentwood, NY 11717-4306 Ph: (631) 231-1401 | Ny Foot & Ankle Specialist Dpm Pc 620 Suffolk Ave, Brentwood, NY 11717 Ph: (631) 231-1401 |
Ny Foot & Ankle Specialists Dpm Pc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 620 Suffolk Ave, Brentwood, NY 11717 Phone: 631-231-1401 | |
Dr. Peter John Mancuso, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 620 Suffolk Ave, Brentwood, NY 11717 Phone: 631-231-1401 Fax: 631-273-0125 | |
Optimum Podiatry Group Pllc Podiatrist Medicare: Medicare Enrolled Practice Location: 620 Suffolk Ave, Brentwood, NY 11717 Phone: 631-968-5600 |