MEDICARE: EUGENE DEMARZO DPM

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	MD01835	NJ
2	213ES0131X	Foot Surgery Podiatrist	MD01835	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750364469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE DEMARZO DPM

Provider Business Mailing Address
First Line	:	570 RAHWAY AVE
Second Line	:	PO BOX 1102
City	:	WOODBRIDGE
State	:	NJ
Zip	:	07095-3485
Country	:	US
Telephone Number	:	732-750-2424
Fax Number	:	732-750-2500

Provider Business Practice Location Address
First Line	:	570 RAHWAY AVE
Second Line	:
City	:	WOODBRIDGE
State	:	NJ
Zip	:	07095-3485
Country	:	US
Telephone Number	:	732-750-2424
Fax Number	:	732-750-2500

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

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	04/29/2008

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