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General NPI Number Information
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NPI Number | 1538308952
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Entity Type | Organization
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Legal Business Name | AFFILIATED FOOT & ANKLE SPEC OF TEANECK
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 751 TEANECK RD 1ST FLOOR
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City | TEANECK
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State | NJ
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Zip | 07666-0000
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Country | US
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Telephone | 201-238-1595
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Fax | 201-221-8762
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Provider Business Mailing Address
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Address Line | 751 TEANECK RD 1ST FLOOR
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City | TEANECK
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State | NJ
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Zip | 07666-0000
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Country | US
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Telephone | 201-238-1595
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Fax | 201-221-8762
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY MILLER
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Credential | DPM
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Telephone | 201-238-1595
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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 | 25MD00120300
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License Number State | NJ
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