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General NPI Number Information
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NPI Number | 1083629950
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Entity Type | Organization
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Legal Business Name | REGIONAL FOOT AND ANKLE SPECIALISTS, LLC
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Dates
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Enumeration Date | 07/29/2006
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Last Update Date | 02/19/2018
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Provider Practice Location Address
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Address Line | 188 FRIES MILL RD STE F1
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-2015
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Country | US
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Telephone | 856-875-8855
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Fax | 856-728-5497
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Provider Business Mailing Address
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Address Line | 188 FRIES MILL RD STE F1
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-2015
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Country | US
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Telephone | 856-875-8855
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Fax | 856-728-5497
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH A. MIRARCHI
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Credential | D.P.M.
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Telephone | 856-875-8855
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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 | MD001883
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License Number State | NJ
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