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General NPI Number Information
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NPI Number | 1699889535
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Entity Type | Individual
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Provider Name | JOHN COZZARELLI DPM
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 155 BELLEVILLE AVE
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City | BELLEVILLE
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State | NJ
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Zip | 07109-2407
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Country | US
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Telephone | 973-450-0878
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Fax | 973-450-1013
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Provider Business Mailing Address
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Address Line | 93 N SPRING GARDEN AVE
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City | NUTLEY
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State | NJ
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Zip | 07110-1529
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Country | US
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Telephone | 973-667-7096
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Fax |
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 25MD00188800
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License Number State | NJ
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