| NPI | 1902208044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY ALANA PAUKOVITZ Owner/Physician 732-330-0924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00269900) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2015-07-30 |