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General NPI Number Information
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NPI Number | 1013095975
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Entity Type | Individual
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Provider Name | ANTHONY J ENRICO DPM
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 628 BROADWAY
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City | PATERSON
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State | NJ
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Zip | 07514-1918
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Country | US
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Telephone | 973-278-8001
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Fax | 973-742-6793
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Provider Business Mailing Address
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Address Line | 628 BROADWAY
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City | PATERSON
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State | NJ
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Zip | 07514-1918
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Country | US
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Telephone | 973-278-8001
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Fax | 973-742-6793
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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 | 25MD00172300
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License Number State | NJ
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