MEDICARE: LINWOOD PODIATRY LLC

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

General Provider Information

NPI Number	:	1942989728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINWOOD PODIATRY LLC

Provider Business Mailing Address
First Line	:	222 NEW RD STE 205
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1281
Country	:	US
Telephone Number	:	609-653-2066
Fax Number	:	609-653-8480

Provider Business Practice Location Address
First Line	:	222 NEW RD STE 205
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1281
Country	:	US
Telephone Number	:	609-653-2066
Fax Number	:	609-653-8480

Authorized Official
Title or Position	:	DPM
Name	:	CHARLES MURPHY
Credential	:
Telephone Number	:	609-653-2066

Provider Enumeration Date	:	07/18/2023
Last Update Date	:	07/18/2023

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