MEDICARE: FOOT AND ANKLE INSTITUTE OF NEW JERSEY

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	213E00000X	Podiatrist	25MD00115400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2406739000	OTHER		AMERIHEALTH

General Provider Information

NPI Number	:	1356560544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOOT AND ANKLE INSTITUTE OF NEW JERSEY

Provider Business Mailing Address
First Line	:	5012 WELLINGTON AVE # B
Second Line	:
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406-1443
Country	:	US
Telephone Number	:	609-823-6200
Fax Number	:	609-487-1788

Provider Business Practice Location Address
First Line	:	5012 WELLINGTON AVE # B
Second Line	:
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406-1443
Country	:	US
Telephone Number	:	609-823-6200
Fax Number	:	609-487-1788

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STANLEY AARON BELOFFF
Credential	:	DPM
Telephone Number	:	609-823-6200

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	08/22/2020

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Directions to “FOOT AND ANKLE INSTITUTE OF NEW JERSEY ” Practice Location

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