Healthcare Provider Details

I. General information

NPI: 1699959510
Provider Name (Legal Business Name): CHARLES R SPATZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 07/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 HAZLET AVE STE 6
HAZLET NJ
07730
US

IV. Provider business mailing address

80 HAZLET AVE STE 6
HAZLET NJ
07730-1600
US

V. Phone/Fax

Practice location:
  • Phone: 732-847-3050
  • Fax: 732-212-9338
Mailing address:
  • Phone: 732-847-3050
  • Fax: 732-212-9338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES R SPATZ
Title or Position: PODIATRIST
Credential: DPM
Phone: 732-212-8637