| Organization Name: | NEW JERSEY PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC |
| NPI Number: | 1154750651 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HAL ORNSTEIN (PRESIDENT/MANAGER) |
| Mailing Address: | 717 N Beers St Suite 1d Holmdel |
| State: | NJ US |
| Postal Code: | 077331524 |
| Phone Number: | 7328881003 |
| Fax Number: | 7328884606 |
| NPI Enumeration Date: | 11/05/2013 |
| NPI Last Update Date: | 11/05/2013 |
| 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: | |