| Organization Name: | MAPLEWOOD FOOT AND ANKLE |
| NPI Number: | 1073827804 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL EGLOW (OWNER) |
| Mailing Address: | 40 Greenwood Dr Millburn |
| State: | NJ US |
| Postal Code: | 070411448 |
| Phone Number: | 9737631248 |
| Fax Number: | |
| NPI Enumeration Date: | 08/04/2010 |
| NPI Last Update Date: | 02/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 25MD00137400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |