MEDICARE: DR. EDWARD TJOE D.P.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	25MD00310500	NJ

General Provider Information

NPI Number	:	1245519354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD TJOE D.P.M

Provider Business Mailing Address
First Line	:	66 YORK ST
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3838
Country	:	US
Telephone Number	:	201-984-0231
Fax Number	:	201-918-5377

Provider Business Practice Location Address
First Line	:	66 YORK ST
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3838
Country	:	US
Telephone Number	:	201-984-0231
Fax Number	:	201-918-5377

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2011
Last Update Date	:	04/05/2012

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