Organization Name: | DEBENEDICTIS & TESTA, DPM, PA |
NPI Number: | 1013076256 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAROLINA VILA (CLINICAL MANAGER) |
Mailing Address: | 4808 Bergenline Ave Suite 202 Union City |
State: | NJ US |
Postal Code: | 070875162 |
Phone Number: | 2018630036 |
Fax Number: | 2018630727 |
NPI Enumeration Date: | 12/06/2006 |
NPI Last Update Date: | 01/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0131X |
License Number: | 213ES0131X |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot Surgery |
Taxonomy Definition: |