| NPI | 1033548227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO DAVIDSON Partner 973-429-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 261QP1100X Clinic/Center, Podiatric (Licence: NJ 25MD00229500) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2022-12-08 |