OrganizationEast Patchogue Podiatry P.C.PodiatristPodiatric Medicine & Surgery Service ProvidersPractice Address285 Sills Rd, Bldg 5-6 #H, East Patchogue, NY 11772-4869(631) 654-5566PECOS EnrollmentBased on the most recent information from CMS, provider East Patchogue Podiatry P.C. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:59 AM.Profile DetailsProvider ID1871775726Provider TypeOrganizationFull NameEast Patchogue Podiatry P.C.SubpartNoEnumeration Date12/3/2007Last Updated2/27/2020Contact InformationPractice LocationPractice Address285 Sills Rd, Bldg 5-6 #H, East Patchogue, NY 11772-4869Phone(631) 654-5566FaxUnlisted FaxMailing LocationMailing Address285 Sills Rd, Bldg 5-6 #H, East Patchogue, NY 11772-4869Phone(631) 654-5566FaxUnlisted FaxAuthorized OfficialNameKormylo, Edward James (Owner)Phone(631) 654-5566Provider TaxonomiesCodeDescriptionLicenseCode213E00000XPrimaryDescriptionPodiatristPodiatric Medicine & Surgery Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID00588743DescriptionMedicaidIssuerUnlistedNew York