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General NPI Number Information
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NPI Number | 1518913631
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Entity Type | Organization
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Legal Business Name | ADVANCED FOOT & ANKLE CENTER OF WILLIAMSTOWN, INC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 04/18/2008
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Provider Practice Location Address
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Address Line | 1035 NORTH BLACK HORSE PIKE UNIT 1
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-1043
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Country | US
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Telephone | 856-629-7518
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Fax | 856-629-1838
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Provider Business Mailing Address
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Address Line | 1035 NORTH BLACK HORSE PIKE UNIT 1
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-1043
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Country | US
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Telephone | 856-629-7518
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Fax | 856-629-1838
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JOSEPH PATRICK HALEY
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Credential | DPM
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Telephone | 856-629-7518
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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 | 25MD00241700
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License Number State | NJ
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