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General NPI Number Information
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NPI Number | 1104154475
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Entity Type | Organization
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Legal Business Name | DR. STERN/STRAUSS PODIATRIC PHYSICIANS OF NEW JERSEY
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Dates
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Enumeration Date | 11/25/2009
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 31 - 00 BROADWAY
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City | FAIR LAWN
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State | NJ
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Zip | 07410
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Country | US
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Telephone | 201-796-2255
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Fax |
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Provider Business Mailing Address
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Address Line | 85 LEONARDO CT
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City | WEST ORANGE
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State | NJ
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Zip | 07052-4116
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Country | US
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Telephone | 973-736-5392
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRUCE STERN
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Credential | DPM
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Telephone | 973-736-5392
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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 | 25MD 00099600
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License Number State | NJ
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