Healthcare Provider Details

I. General information

NPI: 1104864610
Provider Name (Legal Business Name): OCEAN FOOT AND ANKLE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LEIFRIED LN SUITE B
LITTLE EGG HARBOR TWP NJ
08087-2000
US

IV. Provider business mailing address

1 LEIFRIED LN SUITE B
LITTLE EGG HARBOR TWP NJ
08087-2000
US

V. Phone/Fax

Practice location:
  • Phone: 609-294-2666
  • Fax: 609-294-0606
Mailing address:
  • Phone: 609-294-2666
  • Fax: 609-294-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberMD 002520
License Number StateNJ

VIII. Authorized Official

Name: DR. JAMES GIANNAKAROS
Title or Position: OWNER
Credential: DPM
Phone: 609-294-2666