Healthcare Provider Details

I. General information

NPI: 1659455848
Provider Name (Legal Business Name): HOBOKEN ANKLE & FOOT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 BLOOMFIELD ST
HOBOKEN NJ
07030
US

IV. Provider business mailing address

500 BLOOMFIELD ST
HOBOKEN NJ
07030
US

V. Phone/Fax

Practice location:
  • Phone: 201-656-4608
  • Fax: 201-656-4633
Mailing address:
  • Phone: 201-656-4608
  • Fax: 201-656-4633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberMD2482
License Number StateNJ

VIII. Authorized Official

Name: DR. WILLIAM JAY LIPKIN
Title or Position: CO OWNER
Credential: DPM
Phone: 201-656-4608