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General NPI Number Information
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NPI Number | 1528361193
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Entity Type | Organization
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Legal Business Name | FOOT AND ANKLE CENTER OF TEANECK PA
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Dates
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Enumeration Date | 12/21/2010
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 185 CEDAR LN U5
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City | TEANECK
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State | NJ
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Zip | 07666-4316
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Country | US
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Telephone | 201-928-0808
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Fax | 201-928-0929
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Provider Business Mailing Address
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Address Line | 185 CEDAR LN U5
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City | TEANECK
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State | NJ
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Zip | 07666-4316
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Country | US
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Telephone | 201-928-0808
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Fax | 201-928-0929
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT S MARCUS
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Credential | D.P.M.
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Telephone | 201-928-0808
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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 | MD02115
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License Number State | NJ
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