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NPI 1063592764ActiveOrganization· Podiatrist· Far Rockaway, NY

Podiatrist in Far Rockaway, New York, registered in NPPES in October 2006. The authorized official on file is Marlena Simpson, Director, Credentialing.

Overview

NPI1063592764
StatusActive
Entity typeOrganization
NPI issuedOct 17, 2006
Last updated in NPPESSep 11, 2025

Specialties and licenses

TaxonomyCodeLicenseState
Podiatrist Primary213E00000X——
Allergy & Immunology207K00000X——
Family Medicine207Q00000X——
Internal Medicine207R00000X——
Internal Medicine, Hematology & Oncology207RH0003X——
Internal Medicine, Pulmonary Disease207RP1001X——
Internal Medicine, Rheumatology207RR0500X——
Obstetrics & Gynecology207V00000X——
Ophthalmology207W00000X——
Orthopaedic Surgery207X00000X——
Pediatrics208000000X——
Pediatrics, Pediatric Allergy/Immunology2080P0201X——
Pediatrics, Pediatric Endocrinology2080P0205X——
Surgery208600000X——
Urology208800000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other podiatrists in Far Rockaway

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