Provider Demographics
NPI:1538601398
Name:BIG APPLE FOOT AND ANKLE CARE PODIATRIC CARE P.C
Entity type:Organization
Organization Name:BIG APPLE FOOT AND ANKLE CARE PODIATRIC CARE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MWANDO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM ,MD
Authorized Official - Phone:646-454-8264
Mailing Address - Street 1:45 W 34TH ST RM 903
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-3100
Mailing Address - Country:US
Mailing Address - Phone:646-454-8264
Mailing Address - Fax:855-312-6352
Practice Address - Street 1:45 W 34TH ST RM 903
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3100
Practice Address - Country:US
Practice Address - Phone:646-454-8264
Practice Address - Fax:855-312-6352
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIG APPLE FOOT AND ANKLE CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006313213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty