Healthcare Provider Details
I. General information
NPI: 1295153732
Provider Name (Legal Business Name): JOHN GIRIMONTE, DPM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2014
Last Update Date: 04/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2301 E EVESHAM RD STE 307
VOORHEES NJ
08043-4503
US
IV. Provider business mailing address
2301 E EVESHAM RD STE 307
VOORHEES NJ
08043-4503
US
V. Phone/Fax
- Phone: 856-772-1777
- Fax:
- Phone: 856-772-1777
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | 25MD00258800 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
JOHN
GIRIMONTE
Title or Position: OWNER/PHYSICIAN
Credential: DPM
Phone: 856-772-1777