| Organization Name: | FOOT AND ANKLE CENTER OF SOUTH JERSEY, LLC |
| NPI Number: | 1174678650 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN DAMIANO (OFFICE MANAGER) |
| Mailing Address: | 750 S White Horse Pike Hammonton |
| State: | NJ US |
| Postal Code: | 080372000 |
| Phone Number: | 6095670606 |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 07/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213EP1101X |
| License Number: | MD001116 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Primary Podiatric Medicine |
| Taxonomy Definition: | |