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General NPI Number Information
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NPI Number | 1649267642
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Entity Type | Individual
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Provider Name | LARRY B PRICE DPM
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Gender | Male
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 322 KINDERKAMACK RD
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City | WESTWOOD
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State | NJ
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Zip | 07675-1635
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Country | US
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Telephone | 201-666-5115
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Fax | 201-666-3703
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Provider Business Mailing Address
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Address Line | 322 KINDERKAMACK RD
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City | WESTWOOD
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State | NJ
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Zip | 07675-1635
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Country | US
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Telephone | 201-666-5115
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Fax | 201-666-3703
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 25MD00100300
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License Number State | NJ
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