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General NPI Number Information
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NPI Number | 1023859485
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Entity Type | Organization
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Legal Business Name | CROSSTOWN PODIATRY
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Dates
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Enumeration Date | 06/01/2024
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Last Update Date | 06/01/2024
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Provider Practice Location Address
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Address Line | 511 S ORANGE AVE
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-2636
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Country | US
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Telephone | 908-285-3217
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Fax | 908-281-9209
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Provider Business Mailing Address
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Address Line | 511 S ORANGE AVE
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-2636
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Country | US
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Telephone | 908-285-3217
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Fax | 908-281-9209
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Authorized Official
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Title or Position | PRESIDENT
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Name | FRANK COLABELLA
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Credential |
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Telephone | 908-285-3217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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