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General NPI Number Information
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NPI Number | 1952409245
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Entity Type | Organization
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Legal Business Name | THE CENTRE FOR FOOT & ANKLE CARE, P.A.
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/22/2008
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Provider Practice Location Address
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Address Line | 403 BETHEL RD
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2188
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Country | US
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Telephone | 609-653-2020
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Fax | 609-653-3110
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Provider Business Mailing Address
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Address Line | 403 BETHEL RD
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City | SOMERS POINT
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State | NJ
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Zip | 08244-2188
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Country | US
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Telephone | 609-653-2020
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Fax | 609-653-3110
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES A CANCILLERI
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Credential | DPM
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Telephone | 609-653-2020
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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 | MD001971
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License Number State | NJ
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