| Organization Name: | FOOT AND ANKLE CARE OF PASSAIC LLC |
| NPI Number: | 1114089679 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SEAN D ROSENBLUM (PRESIDENT) |
| Mailing Address: | 393 Terhune Ave Passaic |
| State: | NJ US |
| Postal Code: | 070552448 |
| Phone Number: | 9732469420 |
| Fax Number: | 7182614220 |
| NPI Enumeration Date: | 12/14/2006 |
| NPI Last Update Date: | 09/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 25MD00278900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |