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General NPI Number Information
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NPI Number | 1710047956
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Entity Type | Organization
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Legal Business Name | CLASSIC PODIATRY
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 655 POMANDER WALK
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City | TEANECK
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State | NJ
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Zip | 07666-1600
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Country | US
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Telephone | 201-801-0631
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Fax |
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Provider Business Mailing Address
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Address Line | 655 POMANDER WALK
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City | TEANECK
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State | NJ
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Zip | 07666-1600
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Country | US
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Telephone | 201-801-0631
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Fax |
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Authorized Official
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Title or Position | PRESIDENT-PARTNER
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Name | DR. JOSEPH MEI
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Credential | D.P.M.
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Telephone | 201-801-0631
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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 | MD02077
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | MD001801
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License Number State | NJ
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