Park South Podiatry LLC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

005362 Issued in NY

Legal business name

PARK SOUTH PODIATRY LLC

Practice address

450 Park Ave S
New York, NY 10016-7320

Phone

(212) 679-6776

Fax

(212) 679-6538

NPI assigned

Nov 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Israel Goldman, D.P.M.

Title

Owner

Phone

(212) 679-6776

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1467739755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 PARK AVE S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100167320",
            "telephone_number": "212-679-6776",
            "fax_number": "212-679-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PARK AVE S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100167320",
            "telephone_number": "212-679-6776",
            "fax_number": "212-679-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK SOUTH PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ISRAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-679-6776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "005362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Podiatric Medicine Podiatrist in New York, NY
• Providers in New York, NY by specialty
• Primary Podiatric Medicine Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.