| NPI | 1255085072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JAMES DONOVAN Owner Physician 732-814-7029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-10-24 |