Healthcare Provider Details
I. General information
NPI: 1962371112
Provider Name (Legal Business Name): OCEAN COUNTY FOOT & ANKLE SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/04/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2911 ROUTE 88 STE 3
POINT PLEASANT BORO NJ
08742-2871
US
IV. Provider business mailing address
PO BOX 825159
PHILADELPHIA PA
19182-5159
US
V. Phone/Fax
- Phone: 732-892-2100
- Fax: 732-892-2111
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GENE
MIRKIN
Title or Position: OWNER
Credential: DPM
Phone: 314-909-1920