Healthcare Provider Details

I. General information

NPI: 1548581069
Provider Name (Legal Business Name): GLOBAL PODIATRY OF NJ PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 ROUTE 9 STE 100
MANALAPAN NJ
07726-3073
US

IV. Provider business mailing address

198 ROUTE 9 STE 100
MANALAPAN NJ
07726-3073
US

V. Phone/Fax

Practice location:
  • Phone: 732-890-3668
  • Fax: 732-595-9095
Mailing address:
  • Phone: 732-890-3668
  • Fax: 732-595-9095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. SERGEY A LOSYEV
Title or Position: DOCTOR
Credential: DPM
Phone: 732-890-3668