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General NPI Number Information
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NPI Number | 1649674334
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Entity Type | Organization
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Legal Business Name | REGIONAL FOOT AND ANKLE SPECIALISTS
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 188 FRIES MILL RD SUITE N2
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-2015
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Country | US
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Telephone | 856-875-8855
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Fax | 856-728-5497
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Provider Business Mailing Address
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Address Line | 188 FRIES MILL RD SUITE N2
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City | TURNERSVILLE
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State | NJ
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Zip | 08012-2015
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Country | US
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Telephone | 856-875-8855
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Fax | 856-728-5497
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Authorized Official
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Title or Position | MANAGER
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Name | JENNA M TRANTAS
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Credential |
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Telephone | 856-875-8855
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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 | 25MD00171400
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License Number State | NJ
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