MEDICARE: CHRISTOPHER OFELDT 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	390200000X	Student in an Organized Health Care Education/Training Program	SC006956	PA
2	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00351400	NJ

General Provider Information

NPI Number	:	1114413416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER OFELDT DPM

Provider Business Mailing Address
First Line	:	2159 ROUTE 88 E
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-3232
Country	:	US
Telephone Number	:	732-899-0015
Fax Number	:	732-899-0061

Provider Business Practice Location Address
First Line	:	2159 ROUTE 88 E
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-3232
Country	:	US
Telephone Number	:	215-612-5161
Fax Number	:	215-612-4069

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

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	09/07/2022

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Directions to “ CHRISTOPHER OFELDT DPM” Practice Location

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