Healthcare Provider Details

I. General information

NPI: 1144775560
Provider Name (Legal Business Name): TOTAL ANKLE & FOOT INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2016
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 HAMBURG TPKE STE B
WAYNE NJ
07470-6251
US

IV. Provider business mailing address

2035 HAMBURG TPKE STE B
WAYNE NJ
07470-6251
US

V. Phone/Fax

Practice location:
  • Phone: 201-614-3668
  • Fax:
Mailing address:
  • Phone: 201-614-3668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HOMAM BADRI
Title or Position: MD/OWNER
Credential:
Phone: 973-330-7444