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NPI Code Detail

MEDICARE: BERGEN FAMILY FOOT CARE, LLC

MEDICARE: BERGEN FAMILY FOOT CARE, LLC
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
1213ES0103XFoot & Ankle Surgery PodiatristMD02533NJ

General Provider Information

NPI Number : 1326182346
Entity Type Code : Organization
Provider Name (Legal Business Name) : BERGEN FAMILY FOOT CARE, LLC
Provider Business Mailing Address
First Line : 67 BROADWAY
Second Line :
City : ELMWOOD PARK
State : NJ
Zip : 07407
Country : US
Telephone Number : 201-794-3223
Fax Number : 201-794-8411
Provider Business Practice Location Address
First Line : 67 BROADWAY
Second Line :
City : ELMWOOD PARK
State : NJ
Zip : 07407-1836
Country : US
Telephone Number : 201-794-3223
Fax Number : 201-794-8411
Authorized Official
Title or Position : OWNER
Name : DR. JOHN JOSEPH CAPONIGRO
Credential : DPM
Telephone Number : 201-794-3223
Provider Enumeration Date : 02/16/2007
Last Update Date : 11/04/2008

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Directions to “BERGEN FAMILY FOOT CARE, LLC ” Practice Location

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