David J. Ellenbogen Podiatry, PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N006125 Issued in NY

Legal business name

DAVID J. ELLENBOGEN PODIATRY, PC

Doing business as

Long Island Foot and Ankle

Practice address

358 Veterans Memorial Hwy
#11
Commack, NY 11725-4326

Phone

(631) 543-8844

Fax

(631) 543-8840

NPI assigned

Oct 29, 2013

Organization subpart

No

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

Authorized official

Name

David J Ellenbogen, DPM

Title

President

Phone

(631) 543-8844

Specialties & licenses 1

Addresses

Other names 1

• Long Island Foot and Ankle Doing business as

Locations

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

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1558799502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 VETERANS MEMORIAL HWY",
            "address_2": "#11",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254326",
            "telephone_number": "631-543-8844",
            "fax_number": "631-543-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 VETERANS MEMORIAL HWY",
            "address_2": "#11",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117254326",
            "telephone_number": "631-543-8844",
            "fax_number": "631-543-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID J. ELLENBOGEN PODIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "ELLENBOGEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-543-8844",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N006125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Long Island Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mary Nancy De la Cruz

• Podiatrist in Commack, NY
• Providers in Commack, NY by specialty
• Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; 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.