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General NPI Number Information
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NPI Number | 1841884673
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Entity Type | Organization
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Legal Business Name | MARLBORO PODIATRY CENTER LLC
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Dates
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Enumeration Date | 02/23/2021
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 223 TAYLORS MILLS RD
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City | MANALAPAN
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State | NJ
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Zip | 07726-3229
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Country | US
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Telephone | 732-780-8787
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Fax | 732-577-1106
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Provider Business Mailing Address
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Address Line | 223 TAYLORS MILLS RD
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City | MANALAPAN
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State | NJ
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Zip | 07726-3229
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Country | US
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Telephone | 732-780-8787
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Fax | 732-577-1106
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Authorized Official
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Title or Position | OWNER
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Name | MARC COHEN
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Credential | DPM
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Telephone | 732-780-8787
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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 |
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License Number State |
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