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General NPI Number Information
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NPI Number | 1518778232
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Entity Type | Organization
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Legal Business Name | MUNTASIR KHALED, DPM LLC
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 230 US HIGHWAY 206 UNIT 5
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City | FLANDERS
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State | NJ
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Zip | 07836-9189
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Country | US
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Telephone | 973-873-0211
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Fax |
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Provider Business Mailing Address
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Address Line | 309 MEMORIAL PKWY
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-4264
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Country | US
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Telephone | 973-873-0211
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Fax |
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Authorized Official
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Title or Position | DPM
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Name | MUNTASIR KHALED
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Credential | DPM
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Telephone | 973-873-0211
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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 |
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License Number State |
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