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General NPI Number Information
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NPI Number | 1225489628
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Entity Type | Organization
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Legal Business Name | NORTH JERSEY PODIATRY SPECIALISTS LLC
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 03/04/2020
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Provider Practice Location Address
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Address Line | 80 E RTE 4 STE 100
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City | PARAMUS
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State | NJ
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Zip | 07652-2647
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Country | US
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Telephone | 201-255-4040
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Fax | 201-255-4023
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Provider Business Mailing Address
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Address Line | PO BOX 625
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City | RIDGEFIELD PARK
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State | NJ
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Zip | 07660-0625
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Country | US
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Telephone | 201-255-4040
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Fax | 201-255-4023
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGIOS KOTZIAS
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Credential | DPM
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Telephone | 201-255-4040
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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 | 25MD00331900
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License Number State | NJ
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