Healthcare Provider Details

I. General information

NPI: 1912120155
Provider Name (Legal Business Name): WESTFIELD FOOT & ANKLE SPECIALISTS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

592B SPRINGFIELD AVE SUITE A
WESTFIELD NJ
07090-1002
US

IV. Provider business mailing address

592B SPRINGFIELD AVE SUITE A
WESTFIELD NJ
07090-1002
US

V. Phone/Fax

Practice location:
  • Phone: 908-232-1060
  • Fax: 908-233-4909
Mailing address:
  • Phone: 908-232-1060
  • Fax: 908-233-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberMD01843
License Number StateNJ

VIII. Authorized Official

Name: DR. SUZAN FAITH CAMPBELL
Title or Position: OWNER
Credential: DPM
Phone: 908-232-1060