| Organization Name: | FOOT & ANKLE ASSOCIATES OF WYCKOFF |
| NPI Number: | 1306001466 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LORI LEE NIEUWENHUIS (OFFICE MANAGER) |
| Mailing Address: | 350 Franklin Ave Suite 2 Wyckoff |
| State: | NJ US |
| Postal Code: | 074811909 |
| Phone Number: | 2018914930 |
| Fax Number: | 2018914715 |
| NPI Enumeration Date: | 07/28/2008 |
| NPI Last Update Date: | 07/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | MB02125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |