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General NPI Number Information
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NPI Number | 1699950881
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Entity Type | Organization
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Legal Business Name | PHILIP J OBIEDZINSKI DPM PA
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 50 ORIENT WAY
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City | RUTHERFORD
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State | NJ
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Zip | 07070
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Country | US
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Telephone | 201-939-2774
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Fax | 201-935-6812
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Provider Business Mailing Address
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Address Line | 50 ORIENT WAY
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City | RUTHERFORD
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State | NJ
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Zip | 07070
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Country | US
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Telephone | 201-939-2774
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Fax | 201-935-6812
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. PHILIP J OBIEDZINSKI
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Credential | DPM
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Telephone | 201-939-2774
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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 | 25MD00126000
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License Number State | NJ
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