| NPI | 1477744555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL HAGEN President 201-568-6977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ MD1961) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ MD1961) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2009-07-31 |