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General NPI Number Information
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NPI Number | 1285626697
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Entity Type | Individual
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Provider Name | MARC JAY SCHLEMOVITZ DPM
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 121 CENTER GROVE RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-4453
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Country | US
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Telephone | 973-366-1016
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Fax | 973-366-5925
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Provider Business Mailing Address
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Address Line | 121 CENTER GROVE RD
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City | RANDOLPH
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State | NJ
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Zip | 07869-4453
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Country | US
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Telephone | 973-366-1016
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Fax | 973-366-5925
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 25MD00111900
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License Number State | NJ
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