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General NPI Number Information
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NPI Number | 1003455544
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Entity Type | Organization
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Legal Business Name | GOFOOTCARE LLC
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Dates
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Enumeration Date | 01/02/2020
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 550 SUMMIT AVE BSMT
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City | JERSEY CITY
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State | NJ
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Zip | 07306-2707
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Country | US
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Telephone | 201-771-3338
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Fax | 855-406-5493
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Provider Business Mailing Address
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Address Line | PO BOX 242
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City | KEARNY
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State | NJ
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Zip | 07032-0242
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Country | US
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Telephone | 201-771-3338
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Fax | 855-406-5493
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. VENANTE CHARLES
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Credential | DPM
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Telephone | 201-771-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number |
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License Number State |
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