SOUTH SHORE MALL PODIATRIC SVC — OIG Excluded Provider (HICKSVILLE, NY, 1128b4)
SOUTH SHORE MALL PODIATRIC SVC — OIG Excluded Provider (HICKSVILLE, NY, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: SOUTH SHORE MALL PODIATRIC SVC; Type: Entity; Provider category: PODIATRY PRACTICE.
| Name | SOUTH SHORE MALL PODIATRIC SVC |
|---|---|
| Type | Entity |
| Provider category | PODIATRY PRACTICE |
| City | HICKSVILLE |
| State | NY |
| ZIP | 11706 |
| Exclusion authority | 1128b4 |
| Exclusion reason | License revocation, suspension, or surrender |
| Exclusion date | 1994-12-07 |
| Source | HHS-OIG LEIE |
$1499/mo
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