Healthcare Provider Details

I. General information

NPI: 1831210517
Provider Name (Legal Business Name): NEW JERSEY FOOT AND ANKLE ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 01/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 STATE ROUTE 27 SUITE 101
NORTH BRUNSWICK NJ
08902-1380
US

IV. Provider business mailing address

2050 STATE ROUTE 27 SUITE 101
NORTH BRUNSWICK NJ
08902-1380
US

V. Phone/Fax

Practice location:
  • Phone: 732-821-2400
  • Fax: 732-821-2426
Mailing address:
  • Phone: 732-821-2400
  • Fax: 732-821-2426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00231900
License Number StateNJ

VIII. Authorized Official

Name: DR. ROBERT ZANNELLA
Title or Position: OWNER OPERATOR
Credential: DPM, FACFAS
Phone: 732-821-2400