| NPI | 1568966505 |
|---|---|
| Doing Business As | PREMIERE FOOT AND ANKLE SPECIALIST |
| Entity Type | Organization |
| Authorized Contact | KARINA CORONA Billing Manager 201-659-5222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-06-16 |