Healthcare Provider Details

I. General information

NPI: 1528084811
Provider Name (Legal Business Name): PAMELA C. FERA TOLA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2089 KLOCKNER RD
HAMILTON NJ
08690-3416
US

IV. Provider business mailing address

2089 KLOCKNER RD
HAMILTON NJ
08690-3416
US

V. Phone/Fax

Practice location:
  • Phone: 609-588-5474
  • Fax: 609-588-4949
Mailing address:
  • Phone: 609-588-5474
  • Fax: 609-588-4949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00210400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: