MEDICARE: PODIATRIC MANAGEMENT

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	213EP1101X	Primary Podiatric Medicine Podiatrist		NJ

General Provider Information

NPI Number	:	1760540496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PODIATRIC MANAGEMENT

Provider Business Mailing Address
First Line	:	24 MERCHANT ST
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07105-2847
Country	:	US
Telephone Number	:	973-589-5184
Fax Number	:	973-762-5056

Provider Business Practice Location Address
First Line	:	24 MERCHANT ST
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07105-2847
Country	:	US
Telephone Number	:	973-589-5184
Fax Number	:	973-762-5056

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. JEFFREY NEIL KAPLAN
Credential	:	D.P.M.
Telephone Number	:	973-477-1606

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	09/17/2007

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Directions to “PODIATRIC MANAGEMENT ” Practice Location

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