Healthcare Provider Details

I. General information

NPI: 1700817186
Provider Name (Legal Business Name): ACHILLES FOOT AND ANKLE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9234 KENNEDY BLVD
NORTH BERGEN NJ
07047-5312
US

IV. Provider business mailing address

9234 KENNEDY BLVD
NORTH BERGEN NJ
07047-5312
US

V. Phone/Fax

Practice location:
  • Phone: 201-868-2400
  • Fax: 201-868-2014
Mailing address:
  • Phone: 201-868-2400
  • Fax: 201-868-2014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number25MD00105200
License Number StateNJ

VIII. Authorized Official

Name: DR. FRANKLIN N. LEVINSON
Title or Position: MANAGING PARTNER
Credential: DPM
Phone: 201-868-2400