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General NPI Number Information
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NPI Number | 1225151509
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Entity Type | Organization
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Legal Business Name | LYNDHURST PODIATRY, P.C.
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 737 RIDGE RD
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City | LYNDHURST
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State | NJ
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Zip | 07071-3215
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Country | US
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Telephone | 201-939-5877
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Fax | 201-939-5115
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Provider Business Mailing Address
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Address Line | 737 RIDGE RD
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City | LYNDHURST
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State | NJ
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Zip | 07071-3215
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Country | US
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Telephone | 201-939-5877
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Fax | 201-939-5115
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT L. BRIGANTI JR.
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Credential | D.P.M.
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Telephone | 201-939-5877
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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 | 25MD2324
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License Number State | NJ
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