Modern Podiatry PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

N006148 Issued in NY

Legal business name

MODERN PODIATRY PC

Practice address

1075 Ocean Pkwy
Medical Office
Brooklyn, NY 11230-4056

Phone

(917) 751-8586

NPI assigned

Sep 20, 2011

Organization subpart

No

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

Authorized official

Name

Inna Verzub, DPMNPI 1952354490

Title

Owner

Phone

(917) 751-8586

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Inna Verzub

  • Podiatrist
  • Brooklyn, NY
  • NPI 1952354490
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1861775496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 OCEAN PKWY",
            "address_2": "MEDICAL OFFICE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 OCEAN PKWY",
            "address_2": "MEDICAL OFFICE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112304056",
            "telephone_number": "917-751-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "VERZUB",
        "authorized_official_first_name": "INNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-751-8586",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N006148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Modern Medical Supply Inc
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• Modern Optika ,Inc
• Modern Pediatrics of Great New York, PC
• Modern Physician Services PC
• Modern Psychiatric Nurse Practitioner PC
• Modern Psychiatric Services, P.C.
• Modern Remedies LLC
• Modern Urology PLLC
• Modern Vision, Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.