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1346781614 NPI number — WOODBURY FOOT CARE CENTRE LLC

NPI Number: 1346781614
Health Care Provider/Practitioner: WOODBURY FOOT CARE CENTRE LLC

Information about “1346781614” NPI (WOODBURY FOOT CARE CENTRE LLC) exists in 1346781614 in HTML format HTML  |  1346781614 in plain Text format TXT  |  1346781614 in PDF (Portable Document Format) PDF  |  1346781614 in an XML format XML  formats.

NPI Number : 1346781614 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1346781614",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "WOODBURY FOOT CARE CENTRE LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "722 MANTUA PIKE",
    "SecondLineMailingAddress": "SUITE10",
    "MailingAddressCityName": "WOODBURY HEIGHTS",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "08097-1141",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "856-384-1333",
    "MailingAddressFaxNumber": "856-384-1297",
    "FirstLinePracticeLocationAddress": "722 MANTUA PIKE",
    "SecondLinePracticeLocationAddress": "SUITE10",
    "PracticeLocationAddressCityName": "WOODBURY HEIGHTS",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "08097-1141",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "856-384-1333",
    "PracticeLocationAddressFaxNumber": "856-384-1297",
    "EnumerationDate": "03/20/2017",
    "LastUpdateDate": "03/21/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HERSKOWITZ",
    "AuthorizedOfficialFirstName": "AMY",
    "AuthorizedOfficialMiddleName": "BETH",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DPM",
    "AuthorizedOfficialTelephoneNumber": "856-384-1333",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "213E00000X",
          "TaxonomyName": "Podiatrist",
          "LicenseNumber": "25MD00208400",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "213ES0103X",
          "TaxonomyName": "Foot & Ankle Surgery Podiatrist",
          "LicenseNumber": "25MD00328100",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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