Healthcare Provider Details

I. General information

NPI: 1679969471
Provider Name (Legal Business Name): COMPLETE FOOT AND ANKLE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 04/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 MONMOUTH RD BUILDING B SUITE 5
OAKHURST NJ
07755-1500
US

IV. Provider business mailing address

257 MONMOUTH RD BUILDING B SUITE 5
OAKHURST NJ
07755-1500
US

V. Phone/Fax

Practice location:
  • Phone: 973-839-1003
  • Fax: 973-839-3653
Mailing address:
  • Phone: 973-839-1003
  • Fax: 973-839-3653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number25MD00194000
License Number StateNJ

VIII. Authorized Official

Name: DR. FRANCES FITTANTO
Title or Position: OWNER/PROVIDER
Credential: DPM
Phone: 973-839-1003