MEDICARE: JOSE GRULLON 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

General Provider Information

NPI Number	:	1396456836
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSE GRULLON DPM

Provider Business Mailing Address
First Line	:	6301 KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-3420
Country	:	US
Telephone Number	:	201-662-8700
Fax Number	:	201-453-8075

Provider Business Practice Location Address
First Line	:	6301 KENNEDY BLVD
Second Line	:
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-3420
Country	:	US
Telephone Number	:	201-662-8700
Fax Number	:	201-453-8075

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MEHTAB ABBASI
Credential	:
Telephone Number	:	917-336-8422

Provider Enumeration Date	:	12/06/2022
Last Update Date	:	12/06/2022

Similar Medicare Providers

1811576895 — QIYUN JENNIFER JIANG
Practice Location Address:

6301 KENNEDY BLVD
NORTH BERGEN, NJ
07047-3420

Practice Phone: 201-662-8700
Practice Fax:

1235125238 — DR. SANDY AMADOR DPM
Practice Location Address:

6301 KENNEDY BLVD
NORTH BERGEN, NJ
07047-3420

Practice Phone: 201-662-8700
Practice Fax: 201-453-8075

1053436519 — MARIBEL CONTRERAS D.C.
Practice Location Address:

6307 KENNEDY BLVD
NORTH BERGEN, NJ
07047-3420

Practice Phone: 201-453-2211
Practice Fax: 201-453-2212

1013208503 — RUBY REY
Practice Location Address:

6313 KENNEDY BLVD
NORTH BERGEN, NJ
07047-3420

Practice Phone: 201-861-3004
Practice Fax:

1386182954 — ELIZABETH MITCHKO
Practice Location Address:

14297 BERGEN BLVD STE 125
NOBLESVILLE, IN
46060-3420

Practice Phone: 317-900-1633
Practice Fax:

1477204550 — WELL INFUSED, LLC
Practice Location Address:

14297 BERGEN BLVD STE 125
NOBLESVILLE, IN
46060-3420

Practice Phone: 317-674-8857
Practice Fax:

Directions to “JOSE GRULLON DPM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.