Healthcare Provider Details

I. General information

NPI: 1255267290
Provider Name (Legal Business Name): MONMOUTH FOOT & ANKLE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 HIGHWAY 35 STE 150
RED BANK NJ
07701-5900
US

IV. Provider business mailing address

280 HIGHWAY 35 STE 150
RED BANK NJ
07701-5900
US

V. Phone/Fax

Practice location:
  • Phone: 646-612-7493
  • Fax: 646-612-7493
Mailing address:
  • Phone: 646-612-7493
  • Fax: 646-612-7493

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: NEHA J PATHAK
Title or Position: OWNER
Credential: DPM
Phone: 614-537-2453