THEODORE RANDOLPH, D.P.M
Podiatrist - Foot & Ankle Surgery
Active
Individual
NPI: 1831197318
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Podiatrist - Foot & Ankle Surgery | 213ES0103X | Yes | 003646 (NY) |
Frequently Asked Questions
NPI 1831197318 is the National Provider Identifier for THEODORE RANDOLPH, D.P.M, a Podiatrist - Foot & Ankle Surgery provider located in Port Jefferson Station, NY. This NPI was enumerated on July 8, 2005.
THEODORE RANDOLPH, D.P.M practices at 3 MEDICAL DR, SUITE C, Port Jefferson Station, NY 11776.
Quick Facts
- NPI
- 1831197318
- Type
- Individual
- Enumerated
- Jul 8, 2005
- Last Updated
- Oct 20, 2011
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