DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

THEODORE JOHN RANDOLPH, D.P.M

Active Sole Proprietor

THEODORE JOHN RANDOLPH, D.P.M is a Foot & Ankle Surgery Podiatrist healthcare provider located in PORT JEFFERSON STATION, New York. NPI 1831197318 is currently active in the NPPES registry. Verify at CMS.

Foot & Ankle Surgery Podiatrist · PORT JEFFERSON STATION, NY

Registration Details

NPI Number
1831197318
Provider Type
Individual
Gender
Male
NPI Issued
Jul 8, 2005 (20.918520994884 yrs)
Last Updated
Oct 20, 2011
License
003646 (NY)
Sole Proprietor
Yes

Practice Information

Address
3 MEDICAL DR
SUITE C
PORT JEFFERSON STATION, NY, 117761597
Browse NY providers · Browse ZIP 11776
Phone
6319287785
Fax
6319280316
Primary Specialty
Foot & Ankle Surgery Podiatrist
213ES0103X

Other Foot & Ankle Surgery Podiatrist Providers in PORT JEFFERSON STATION, NY

Name Credential NPI
DR. MEENAKSHI SINGHAL DPM 1568886539
RONIKA SETHI DPM 1396206538
DUAN ZHANG 1013571520
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.