| Organization Name: | ALLAIRE FOOT & ANKLE |
| NPI Number: | 1154506400 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON D LARSON (OWNER) |
| Mailing Address: | 2399 Hwy 34 Suite A6 Manasquan |
| State: | NJ US |
| Postal Code: | 08736 |
| Phone Number: | 7325288223 |
| Fax Number: | 7325287057 |
| NPI Enumeration Date: | 01/07/2008 |
| NPI Last Update Date: | 07/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 25MD00100900 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |