| NPI | 1720517360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER PONCE Doctor 201-960-1512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NJ 25MD00246800) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2019-05-22 |