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General NPI Number Information
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NPI Number | 1952494510
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY FOOT & ANKLE CENTERS
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 570 HADDON AVE
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City | COLLINGSWOOD
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State | NJ
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Zip | 08108-1449
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Country | US
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Telephone | 856-854-3093
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Fax | 856-854-7969
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Provider Business Mailing Address
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Address Line | 570 HADDON AVE
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City | COLLINGSWOOD
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State | NJ
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Zip | 08108-1449
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Country | US
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Telephone | 856-854-3093
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Fax | 856-854-7969
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID CHARLES KRAATZ
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Credential | DPM
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Telephone | 856-854-3093
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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 | 25MD00145200
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License Number State | NJ
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