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General NPI Number Information
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NPI Number | 1851577639
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Entity Type | Organization
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Legal Business Name | FEOLA FOOT AND ANKLE ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 100 BELCHASE DR SUITE 103
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-9728
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Country | US
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Telephone | 732-583-4800
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Fax | 732-583-0448
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Provider Business Mailing Address
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Address Line | 100 BELCHASE DR STE 103
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City | MATAWAN
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State | NJ
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Zip | 07747-9728
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Country | US
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Telephone | 732-583-4800
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Fax | 732-583-0448
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS J FEOLA
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Credential | DPM
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Telephone | 732-583-4800
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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 | 25MD002635
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License Number State | NJ
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