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General NPI Number Information
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NPI Number | 1932920196
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Entity Type | Organization
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Legal Business Name | NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP, LLC
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1500 PLEASANT VALLEY WAY STE 204
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City | WEST ORANGE
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State | NJ
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Zip | 07052-2956
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Country | US
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Telephone | 923-731-1266
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Fax | 973-731-1712
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Provider Business Mailing Address
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Address Line | 4633 HWY 9
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City | HOWELL
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State | NJ
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Zip | 07731-3324
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | CHERYL MARTINETTI
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Credential |
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Telephone | 732-994-5333
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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 |
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License Number State |
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