| NPI | 1639596547 |
|---|---|
| Other Name | FOOT AND ANKLE CENTER OF FORT LEE, LLC |
| Entity Type | Organization |
| Authorized Contact | GAVRIIL KHAIMOV President 201-363-9844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N006045) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2020-05-15 |