Healthcare Provider Details

I. General information

NPI: 1144803636
Provider Name (Legal Business Name): ESTHER EXANTUS DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 CLYDE RD STE 103
SOMERSET NJ
08873-5034
US

IV. Provider business mailing address

150 BERGEN ST
NEWARK NJ
07103-2496
US

V. Phone/Fax

Practice location:
  • Phone: 732-412-1282
  • Fax: 732-412-1280
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00382600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: