MEDICARE: DR. PHILIP JOSEPH OBIEDZINSKI DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00126000	NJ

General Provider Information

NPI Number	:	1003811019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP JOSEPH OBIEDZINSKI DPM

Provider Business Mailing Address
First Line	:	50 ORIENT WAY
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-2036
Country	:	US
Telephone Number	:	201-939-2774
Fax Number	:	201-935-6812

Provider Business Practice Location Address
First Line	:	50 ORIENT WAY
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-2036
Country	:	US
Telephone Number	:	201-939-2774
Fax Number	:	201-935-6812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	03/08/2011

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Directions to “ DR. PHILIP JOSEPH OBIEDZINSKI DPM” Practice Location

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