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General NPI Number Information
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NPI Number | 1154481232
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Entity Type | Organization
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Legal Business Name | DR. ALFRED J. IEZZI JR. PC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3101 SUNSET AVE
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City | LONGPORT
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State | NJ
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Zip | 08403-1436
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Country | US
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Telephone | 609-335-8275
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 SUNSET AVE
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City | LONGPORT
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State | NJ
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Zip | 08403-1436
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Country | US
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Telephone | 609-335-8275
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALFRED J IEZZI
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Credential | DPM
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Telephone | 609-335-8275
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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 | MD1211
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License Number State | NJ
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