SOUTH ISLAND PODIATRY SPECIALISTS,PC (NPI# 1376607713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376607713 |
| Entity Type | Organization |
| Organization Name | SOUTH ISLAND PODIATRY SPECIALISTS,PC |
| Practice Address |
1641 Route 112 Medford NY 11763-3635 |
| Practice Telephone | 6314470800 |
| Practice Fax Number | 6314470801 |
| Mailing Telephone | 6314470800 |
| Mailing Fax Number | 6314470801 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2008-06-13 |
| Authorized Official Name | DR. WAYNE JOSEPH BODAMER (PRESIDENT) |
| Authorized Official Telephone | 6314470800 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
N0-3889 | NY | Podiatric Medicine & Surgery Service Providers |
| Street Address |
1641 ROUTE 112 |
| City | MEDFORD |
| State | NY |
| Zip Code | 11763-3635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063455392 | Alison Dawn Silhanek | Podiatrist | 1641 Route 112, Medford, NY 11763-3635 | 2006-06-14 |
| 1659848802 | Suffolk Foot and Ankle | Clinic/Center | 1641 Route 112, Medford, NY 11763-3663 | 2018-10-25 |
| 1396189585 | Sara El Bashir | Podiatrist | 1641 Route 112, Medford, NY 11763-3663 | 2013-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316572027 | Rebecca Molino | Specialist | 9, 3251 Ny-112 #2, Medford, NY 11763 | 2020-03-03 |
| 1295203677 | Hajar Taman | Pharmacist | 2975 Horseblock Road, Medford, NY 11763 | 2018-11-05 |
| 1265917041 | Bay Taxi Inc | Taxi | 36/94 Horseblock Rd, Medford, NY 11763 | 2018-09-27 |
| 1184108383 | Bay Taxi Inc | Taxi | 36/94 Horsblock Road, Medford, NY 11763 | 2018-09-24 |
| 1215419650 | Megan Bell | Speech-Language Pathologist | 135 Buffalo Avenue, Medford, NY 11763 | 2018-09-01 |
| 1922592906 | Elizabeth L Oakley | Specialist | 1 Sprat St, Medford, NY 11763 | 2018-06-21 |
| 1609383389 | Federation of Organizations for The New York State Mentally Disabled | Clinic/Center | 3390 Route 112 Ste B, Medford, NY 11763 | 2018-01-04 |
| 1497109607 | Tabitha Aitken | Massage Therapist | 28 Masem Ct, Medford, NY 11763 | 2016-04-14 |
| 1518326685 | Betty Velez | Specialist | 21 Red Pine Rd, Medford, NY 11763 | 2016-02-18 |
| 1134527054 | Angelo L D'esposito | Social Worker | 77 Robinson Ave, Medford, NY 11763 | 2014-12-09 |
| Find all providers in zip 11763 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902809411 | Raymond S. Murano | Podiatrist | 101 Main St, Ste 207, Medford, MA 02155-4530 | 2005-05-30 |
| 1750743084 | Kadin Foot & Ankle Center PC | Podiatrist | 128 Route 70, Suite 14, Medford, NJ 08055-2371 | 2016-03-25 |
| 1134521750 | Devin Dimond | Podiatrist | 1904 E Barnett Rd, Medford, OR 97504-8262 | 2014-09-26 |
| 1316205909 | Jill Francine Ashcraft | Podiatrist | 26 City Hall Mall, Medford, MA 02155-4754 | 2012-05-02 |
| 1366768699 | William David Goforth | Podiatrist | 490 Murphy Rd, Medford, OR 97504-8144 | 2010-04-12 |
| 1730358664 | Raymond S. Murano Dpm PC | Podiatrist | 101 Main St, Suite 207, Medford, MA 02155-4540 | 2008-02-25 |
| 1871504035 | Thomas W Perendy | Podiatrist | 143 S Gibson St, Medford, WI 54451-1622 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518566108 | Vu Nguyen Corp | Podiatrist | 8622 Bay Pkwy Ste 2b, Brooklyn, NY 11214-4170 | 2020-10-23 |
| 1255930079 | Atlantic Podiatry Pllc | Podiatrist | 489 Atlantic Ave # 1a, Brooklyn, NY 11217-2985 | 2020-10-22 |
| 1891393906 | Finger Lakes Podiatry of Geneva, Pllc | Podiatrist | 220 Phoenix Mills Plz, Victor, NY 14564-1414 | 2020-10-12 |
| 1497378699 | Zh Podiatrist of Westchester PC | Podiatrist | 150 Edgepark Rd, White Plains, NY 10603-2106 | 2020-05-21 |
| 1528696259 | Capital District Podiatry, Pllc | Podiatrist | 855 Route 146 Bldg B, Clifton Park, NY 12065-3885 | 2020-03-30 |
| 1629615588 | Kelly Lucas Dpm PC | Podiatrist | 925 Hempstead Tpke Ste 110, Franklin Square, NY 11010-3636 | 2019-12-10 |
| 1811544257 | Christopher Chow Dpm PC | Podiatrist | 749 61st St Ste 503, Brooklyn, NY 11220-4211 | 2019-08-21 |
| 1063074565 | Balance Foot and Ankle LLC | Podiatrist | 611 Mitchel Field Way, Garden City, NY 11530-5057 | 2019-07-03 |
| 1083270979 | Jones Thomas | Podiatrist | 518 Terrace Blvd, New Hyde Park, NY 11040-4343 | 2019-05-15 |
| 1316419690 | Rockaway Podiatry Pllc | Podiatrist | 1957 Flatbush Ave, Brooklyn, NY 11234-2819 | 2018-12-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.