Podiatry Doctor PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PODIATRY DOCTOR PC

Practice address

16110 Jamaica Ave
Jamaica, NY 11432-6139

Phone

(718) 618-6528

NPI assigned

Jun 5, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emmanual Fuzaylov, DPM

Title

Medical Director/Provider

Phone

(718) 618-6528

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1306338371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16110 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114326139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114326139",
            "telephone_number": "718-618-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY DOCTOR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-05",
        "last_updated": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "FUZAYLOV",
        "authorized_official_first_name": "EMMANUAL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/PROVIDER",
        "authorized_official_telephone_number": "718-618-6528",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE JOINT COMMISSION",
            "identifier": "574772",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerane S Plummer, COTA/L
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• Marie Pluviose
• Anahi Poblano Cuaya
• Podiatric Care & Diagnostics, PC
• Podiatry Nyc P.C.
• Joseph Chaim Podrobinok, M.D.
• Kristen Polanco
• Lilibeth Polanco, LCSW
• Sandra Polanco

• Foot & Ankle Surgery Podiatrist in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.