Suffolk Foot and Ankle

NPI #1659848802 in Medford, New York

Provider Information

NPI Number
1659848802
Entity Type
Organization
Organization Name
Suffolk Foot and Ankle
Subpart
Yes (part of a larger organization)
Parent Organization
EAST PATCHOGUE PODIATRY P.C.
Primary Specialty
Clinic/Center - Podiatric
Enumeration Date
Oct 25, 2018
Last Updated
Oct 25, 2018

Practice Location

Address
1641 ROUTE 112
ZIP Code
11763-3663
Phone
(631) 447-0800

Authorized Official

Name
DR. EDWARD J KORMYLO, CPM
Title
PHYSICIAN
Phone
(631) 654-5566

Specialties & Taxonomy Codes

Specialty
Clinic/Center - PodiatricPodiatric

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