=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750443065
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAL ORNSTEIN ET AL PTR AFFILIATED FOOT & ANKLE CENTER LLP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/14/2006
-----------------------------------------------------
Last Update Date | 04/22/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4645 HWY 9
-----------------------------------------------------
City | HOWELL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07731-3324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-905-1110
-----------------------------------------------------
Fax | 732-905-7885
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 822528
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19182-2528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-905-1110
-----------------------------------------------------
Fax | 732-905-7885
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING ADMINISTRATOR
-----------------------------------------------------
Name | GISEL STEPHEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 732-905-7202
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------