| Organization Name: | JERSEY SHORE PODIATRIC ASSOCIATES |
| NPI Number: | 1013203371 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EVA GEE (OFFICE MANAGER) |
| Mailing Address: | 1115 Arnold Ave Pt Pleasant |
| State: | NJ US |
| Postal Code: | 087422384 |
| Phone Number: | 7328922100 |
| Fax Number: | 7328922111 |
| NPI Enumeration Date: | 06/24/2011 |
| NPI Last Update Date: | 06/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 25MD00282000 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |