Organization · Type 2 NPI
Theodore Randolph,dpm
Foot & Ankle Surgery Podiatrist · Port Jefferson Station, NY
NPI number
1720264252
Active
Practice location
3 Medical Dr, Suite C
Port Jefferson Station, NY 11776-1597
Fax (631) 928-0316
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | 003646 (NY) |
Foot & Ankle Surgery Podiatrist: Definition to come...
2 other providers at this address
About NPI 1720264252
Theodore Randolph,dpm's National Provider Identifier is 1720264252, issued on Jan 15, 2008. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Port Jefferson Station, NY. The record was last updated on Jan 16, 2008.