Healthcare Provider Details

I. General information

NPI: 1639142730
Provider Name (Legal Business Name): FOOT CARE ASSOCIATES P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

488 SCHOOLEYS MTN RD HASTINGS COMMONS BLDG. 1B
HACKETTSTOWN NJ
07840-4001
US

IV. Provider business mailing address

488 SCHOOLEYS MTN RD HASTINGS COMMONS BLDG. 1B
HACKETTSTOWN NJ
07840-4001
US

V. Phone/Fax

Practice location:
  • Phone: 908-852-0229
  • Fax: 908-852-1076
Mailing address:
  • Phone: 908-852-0229
  • Fax: 908-852-1076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00171800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNJ

VIII. Authorized Official

Name: MS. LAURA A. MOLITERNO
Title or Position: OFFICE MANAGER
Credential:
Phone: 908-852-0229