Healthcare Provider Details

I. General information

NPI: 1063550358
Provider Name (Legal Business Name): MEDICAL FOOT CARE CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 ORANGE ST SUITE# 301
NEWARK NJ
07107-2944
US

IV. Provider business mailing address

PO BOX 337
ORANGE NJ
07051-0337
US

V. Phone/Fax

Practice location:
  • Phone: 973-485-6799
  • Fax: 973-485-6711
Mailing address:
  • Phone: 908-527-2909
  • Fax: 908-634-1000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. GRETCHEN HAYNES CARTER
Title or Position: OWNER
Credential: DPM
Phone: 973-485-6799