Organization Name: | NEW JERSEY PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC |
NPI Number: | 1114357175 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HAL ORNSTEIN (PRESIDENT/MANAGER) |
Mailing Address: | 53 Main St Sayreville |
State: | NJ US |
Postal Code: | 088721559 |
Phone Number: | 7326794330 |
Fax Number: | 7326794777 |
NPI Enumeration Date: | 11/12/2013 |
NPI Last Update Date: | 11/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 25MD00268400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |