Healthcare Provider Details

I. General information

NPI: 1306183413
Provider Name (Legal Business Name): CORINNE KAUDERER DPM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2013
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HOSPITAL PLZ STE 204
OLD BRIDGE NJ
08857-3084
US

IV. Provider business mailing address

7713 13TH AVE
BROOKLYN NY
11228-2413
US

V. Phone/Fax

Practice location:
  • Phone: 732-414-1150
  • Fax: 718-236-2020
Mailing address:
  • Phone: 718-232-2100
  • Fax: 718-236-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CORINNE R KAUDERER
Title or Position: OWNER
Credential: DPM
Phone: 732-414-1150