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General NPI Number Information
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NPI Number | 1366556276
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Entity Type | Organization
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Legal Business Name | PODIATRIC HEALTH ASSOCIATES, P.C.
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 6 FRANKLIN AVE
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City | OAKLAND
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State | NJ
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Zip | 07436-3420
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Country | US
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Telephone | 908-358-9127
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Fax |
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Provider Business Mailing Address
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Address Line | 6 FRANKLIN AVE
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City | OAKLAND
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State | NJ
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Zip | 07436-3420
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Country | US
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Telephone | 908-358-9127
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Fax |
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Authorized Official
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Title or Position | REGISTERED AGENT
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Name | DEANA BROWN
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Credential |
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Telephone | 908-358-9127
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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 | MD002549
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License Number State | NJ
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