Provider Demographics
NPI:1164317863
Name:HEEL SOLE PODIATRY PC
Entity type:Organization
Organization Name:HEEL SOLE PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABET
Authorized Official - Middle Name:
Authorized Official - Last Name:PERAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-338-6150
Mailing Address - Street 1:305 E 86TH ST APT 1GW
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:305 E 86TH ST APT 1GW
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4712
Practice Address - Country:US
Practice Address - Phone:914-338-6150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty