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General NPI Number Information
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NPI Number | 1558564419
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Entity Type | Organization
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Legal Business Name | JCE FOOT AND ANKLE SPECIALTIES
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 430 MORRIS AVE
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City | ELIZABETH
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State | NJ
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Zip | 07208-3609
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Country | US
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Telephone | 908-352-1400
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Fax | 908-352-7900
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Provider Business Mailing Address
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Address Line | PO BOX 493
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City | ELIZABETH
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State | NJ
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Zip | 07207-0493
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Country | US
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Telephone | 908-352-1400
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Fax | 908-352-7900
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWIN R ROMAN
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Credential | DPM
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Telephone | 908-352-1400
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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 | 25MD002838
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License Number State | NJ
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