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General NPI Number Information
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NPI Number | 1003499534
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Entity Type | Individual
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Provider Name | ELIAS G LOGOTHETIS DPM
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Gender | Male
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Dates
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Enumeration Date | 05/03/2021
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 64 US HIGHWAY 46 STE 201
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City | PINE BROOK
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State | NJ
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Zip | 07058-4401
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Country | US
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Telephone | 973-995-1901
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Fax | 973-995-1910
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Provider Business Mailing Address
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Address Line | 30 LOWER NOTCH RD
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City | LITTLE FALLS
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State | NJ
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Zip | 07424-1806
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Country | US
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Telephone | 973-934-9704
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | N007353
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00377800
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License Number State | NJ
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