Healthcare Provider Details

I. General information

NPI: 1982846911
Provider Name (Legal Business Name): ANTONIOUS W. ESKANDAR D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 02/17/2020
Certification Date: 02/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 WASHINGTON ST STE 308
EAST ORANGE NJ
07017-1050
US

IV. Provider business mailing address

90 WASHINGTON ST STE 308
EAST ORANGE NJ
07017-1050
US

V. Phone/Fax

Practice location:
  • Phone: 844-273-3428
  • Fax: 973-528-8088
Mailing address:
  • Phone: 347-350-3802
  • Fax: 973-528-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN0006541-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: