Healthcare Provider Details

I. General information

NPI: 1316064736
Provider Name (Legal Business Name): ROBERT I NEUFELD DPM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2092 MORRIS AVE
UNION NJ
07083-6022
US

IV. Provider business mailing address

2092 MORRIS AVE
UNION NJ
07083-6022
US

V. Phone/Fax

Practice location:
  • Phone: 908-688-0113
  • Fax: 908-688-2002
Mailing address:
  • Phone: 908-688-0113
  • Fax: 908-688-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberMD01322
License Number StateNJ

VIII. Authorized Official

Name: DR. ROBERT IRA NEUFELD
Title or Position: DOCTOR SURGEON PODIATRIST
Credential: D.P.M.
Phone: 908-688-0113