Foot and Ankle Center of Fort Lee Podiatry

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

N006045 Issued in NY

Legal business name

FOOT AND ANKLE CENTER OF FORT LEE PODIATRY

Practice address

6939 Yellowstone Blvd
Forest Hills, NY 11375-3795

Phone

(718) 575-3668

Fax

(718) 575-3665

NPI assigned

Mar 28, 2014

Last updated

Aug 11, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gavriil Khaimov, DPMNPI 1669483426

Title

President

Phone

(201) 363-9844

Specialties & licenses 1

Addresses

Other names 1

• FOOT AND ANKLE CENTER OF FORT LEE, LLC Other name

Tax ID family

Foot and Ankle Center of Fort Lee Podiatry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Foot and Ankle Center of Fort Lee Podiatry

  • Foot & Ankle Surgery Podiatrist
  • Flushing, NY
  • NPI 1285051797
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gavriil Khaimov, DPM

  • Foot & Ankle Surgery Podiatrist
  • Fort Lee, NJ
  • NPI 1669483426
  NPD (past) Authorized official

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

{
    "created_epoch": "1395964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1639596547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6939 YELLOWSTONE BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753795",
            "telephone_number": "718-575-3668",
            "fax_number": "718-575-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6939 YELLOWSTONE BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753795",
            "telephone_number": "718-575-3668",
            "fax_number": "718-575-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE CENTER OF FORT LEE PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-28",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "KHAIMOV",
        "authorized_official_first_name": "GAVRIIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-363-9844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N006045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOT AND ANKLE CENTER OF FORT LEE, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "FOOT AND ANKLE CENTER OF FORT LEE, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Abraham David Flug, M.D. ,P.C.
• Brent Fogel, DO
• Trudy Font-Padron, ED.D
• Aldalicia Fontane, MS
• Gweneth Fontanilla
• Footprint Podiatry Care PC
• Footsteps Podiatry PLLC
• Forest Eye Care Optometry, PLLC
• Forest Hills Acupuncture & Physical Therapy PLLC
• Forest Hills Acupuncture, PC

• Foot & Ankle Surgery Podiatrist in Forest Hills, NY
• Providers in Forest Hills, 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 Aug 11, 2026; 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.