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General NPI Number Information
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NPI Number | 1063203982
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE CARE CENTER LLC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 171 RIDGEDALE AVE STE F
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-1764
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Country | US
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Telephone | 973-518-1450
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Fax |
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Provider Business Mailing Address
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Address Line | 31 S HALL CT
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City | PARSIPPANY
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State | NJ
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Zip | 07054-4369
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. MITUL P AJVALIA
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Credential | DPM
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Telephone | 973-518-1450
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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 |
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License Number State |
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