Healthcare Provider Details

I. General information

NPI: 1386003085
Provider Name (Legal Business Name): CORNERSTONE FOOT & ANKLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2016
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KINGS WAY E SUITE D6
SEWELL NJ
08080-2237
US

IV. Provider business mailing address

100 KINGS WAY E SUITE D6
SEWELL NJ
08080-2237
US

V. Phone/Fax

Practice location:
  • Phone: 856-582-6082
  • Fax: 856-582-6083
Mailing address:
  • Phone: 856-582-6082
  • Fax: 856-582-6083

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: NICOLE BAYLINSON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 856-582-6082