Healthcare Provider Details

I. General information

NPI: 1083007736
Provider Name (Legal Business Name): RIVERVIEW FOOT & ANKLE ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2015
Last Update Date: 03/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 APPLEGARTH RD 207
MONROE TOWNSHIP NJ
08831-5347
US

IV. Provider business mailing address

130 MAPLE AVE SUITE 3B
RED BANK NJ
07701-1734
US

V. Phone/Fax

Practice location:
  • Phone: 609-409-8381
  • Fax: 609-409-6891
Mailing address:
  • Phone: 732-747-2111
  • Fax: 732-530-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: STEVEN DEITCH
Title or Position: OWNER
Credential: DPM
Phone: 732-747-2111