Provider Demographics
NPI:1245451525
Name:WESTCHESTER O B S, INC.
Entity type:Organization
Organization Name:WESTCHESTER O B S, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOOM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:914-245-7888
Mailing Address - Street 1:2050 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4108
Mailing Address - Country:US
Mailing Address - Phone:914-245-7888
Mailing Address - Fax:914-245-7909
Practice Address - Street 1:2050 SAW MILL RIVER RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4108
Practice Address - Country:US
Practice Address - Phone:914-245-7888
Practice Address - Fax:914-245-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN004712261QP1100X
NYN004707261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU06471Medicare UPIN
NYU10277Medicare UPIN