| NPI | 1972761435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEAN PETER LICOPANTIS Podiatrist 973-331-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25md00187700) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2014-11-04 |