Organization Name: | FAMILY FOOTCARE |
NPI Number: | 1376766386 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT GALORENZO (OWNER) |
Mailing Address: | 171 Franklin Tpke Waldwick |
State: | NJ US |
Postal Code: | 074631849 |
Phone Number: | 2014478990 |
Fax Number: | 2014474298 |
NPI Enumeration Date: | 04/10/2007 |
NPI Last Update Date: | 02/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 25MD001411NJ |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |