MEDICARE: DR. JOHN A MOSOLINO 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	25MD00122300	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184622748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN A MOSOLINO DPM

Provider Business Mailing Address
First Line	:	810 ABBOTT BLVD
Second Line	:	SUITE G-1
City	:	FORT LEE
State	:	NJ
Zip	:	07024-4151
Country	:	US
Telephone Number	:	201-224-0255
Fax Number	:	201-224-0395

Provider Business Practice Location Address
First Line	:	810 ABBOTT BLVD
Second Line	:	SUITE G-1
City	:	FORT LEE
State	:	NJ
Zip	:	07024-4151
Country	:	US
Telephone Number	:	201-224-0255
Fax Number	:	201-224-0395

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/08/2008

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Directions to “ DR. JOHN A MOSOLINO DPM” Practice Location

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