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General NPI Number Information
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NPI Number | 1447516737
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Entity Type | Organization
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Legal Business Name | CITI WIDE PODIATRY PC
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 01/20/2021
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Provider Practice Location Address
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Address Line | 2727 KENNEDY BLVD
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City | JERSEY CITY
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State | NJ
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Zip | 07306-5507
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Country | US
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Telephone | 201-333-2700
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Fax | 212-996-5562
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Provider Business Mailing Address
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Address Line | 2727 KENNEDY BLVD
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City | JERSEY CITY
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State | NJ
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Zip | 07306-5507
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Country | US
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Telephone | 201-333-2700
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Fax | 212-996-5562
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. ASIMA RAFIQ CHAUDHRY
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Credential | DPM
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Telephone | 201-315-4168
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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 | 006361
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License Number State | NY
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