Healthcare Provider Details

I. General information

NPI: 1154957363
Provider Name (Legal Business Name): OXFORD FOOT AND ANKLE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 CENTRAL AVE STE 102
EAST ORANGE NJ
07018-2838
US

IV. Provider business mailing address

83 ABERDEEN RD
MATAWAN NJ
07747-2720
US

V. Phone/Fax

Practice location:
  • Phone: 973-207-1678
  • Fax: 732-862-1242
Mailing address:
  • Phone: 973-207-1678
  • Fax: 732-862-1242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. SAMUEL BABATUNDE ADEGBOYEGA
Title or Position: OWNER
Credential: DPM
Phone: 973-207-1678