Healthcare Provider Details

I. General information

NPI: 1649457169
Provider Name (Legal Business Name): STUART W HONICK DPM PT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2008
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 N. WHITE HORSE PIKE SUITE 2
HAMMONTON NJ
08037-1866
US

IV. Provider business mailing address

392 N. WHITE HORSE PIKE SUITE 2
HAMMONTON NJ
08037-1866
US

V. Phone/Fax

Practice location:
  • Phone: 609-704-9001
  • Fax: 609-704-8316
Mailing address:
  • Phone: 609-704-9001
  • Fax: 609-704-8316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. STUART W. HONICK
Title or Position: OWNER/PODIATRIST
Credential: DPM
Phone: 609-704-9001