Healthcare Provider Details

I. General information

NPI: 1497816151
Provider Name (Legal Business Name): STUART W. HONICK, D.P.M., P.T., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N WHITE HORSE PIKE SUITE 103
HAMMONTON NJ
08037-1873
US

IV. Provider business mailing address

8 N WHITE HORSE PIKE SUITE 103
HAMMONTON NJ
08037-1873
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 Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00228000
License Number StateNJ

VIII. Authorized Official

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