Provider Demographics
NPI:1730628264
Name:NY STRIDE PODIATRY PLLC
Entity type:Organization
Organization Name:NY STRIDE PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUFVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:718-471-0200
Mailing Address - Street 1:PO BOX 965
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703
Mailing Address - Country:US
Mailing Address - Phone:718-471-0200
Mailing Address - Fax:718-287-9023
Practice Address - Street 1:712 BEACH 20TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3502
Practice Address - Country:US
Practice Address - Phone:718-471-0200
Practice Address - Fax:718-287-9023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty