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General NPI Number Information
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NPI Number | 1275676421
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Entity Type | Organization
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Legal Business Name | ADVANCED PODIATRIC SERVICES
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 341 S EVERGREEN AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-2715
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Country | US
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Telephone | 856-848-3338
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Fax | 856-848-5122
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Provider Business Mailing Address
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Address Line | 341 S EVERGREEN AVE
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City | WOODBURY
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State | NJ
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Zip | 08096-2715
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Country | US
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Telephone | 856-848-3338
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Fax | 856-848-5122
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Authorized Official
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Title or Position | OWNER OPERATER
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Name | DR. JOSEPH A MEGARA III
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Credential | DPM
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Telephone | 856-848-3338
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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 | NJ25MD00273100
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License Number State | NJ
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