| NPI | 1407929631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN DEITCH Owner President 732-747-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00103800) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00256900) |
| 213E00000X Podiatrist (Licence: NJ 25MD00220900) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2010-04-06 |