Organization Name: | NEW JERSEY PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC |
NPI Number: | 1083042139 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HAL ORNSTEIN (PRESIDENT) |
Mailing Address: | 235 Main Ave Passaic |
State: | NJ US |
Postal Code: | 070555501 |
Phone Number: | 9734736665 |
Fax Number: | 9734717308 |
NPI Enumeration Date: | 10/29/2013 |
NPI Last Update Date: | 10/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |