Healthcare Provider Details

I. General information

NPI: 1598735631
Provider Name (Legal Business Name): WILLIAM CHRISTIAN ANANIA SR. DPM, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 TINDALL RD
MIDDLETOWN NJ
07748-2337
US

IV. Provider business mailing address

112 TINDALL RD
MIDDLETOWN NJ
07748-2337
US

V. Phone/Fax

Practice location:
  • Phone: 732-671-3939
  • Fax: 732-671-4799
Mailing address:
  • Phone: 732-671-3939
  • Fax: 732-671-4799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00157600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number25MD00157600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: