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General NPI Number Information
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NPI Number | 1598540155
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Entity Type | Organization
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Legal Business Name | PREMIER LOWER LIMB CLINIC CORP
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Dates
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Enumeration Date | 08/30/2023
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Last Update Date | 08/31/2025
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Provider Practice Location Address
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Address Line | 2761 JOHN F KENNEDY BLVD
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City | JERSEY CITY
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State | NJ
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Zip | 07306-5515
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Country | US
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Telephone | 201-707-1378
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Fax | 682-316-9141
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Provider Business Mailing Address
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Address Line | 2761 JOHN F KENNEDY BLVD
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City | JERSEY CITY
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State | NJ
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Zip | 07306-5515
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Country | US
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Telephone | 201-707-1378
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Fax | 682-316-9141
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. IBRAHIM ELKATTAWY
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Credential | DPM
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Telephone | 201-707-1378
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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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