MEDICARE: OCEAN COUNTY FOOT & ANKLE SURGICAL ASSOCIATES

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	:	1619692027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCEAN COUNTY FOOT & ANKLE SURGICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	54 BEY LEA RD STE 1
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2978
Country	:	US
Telephone Number	:	732-505-9728
Fax Number	:

Provider Business Practice Location Address
First Line	:	194 JACK MARTIN BLVD UNIT 1A
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-7769
Country	:	US
Telephone Number	:	732-458-4911
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	CHRISTINE MORRIS
Credential	:
Telephone Number	:	732-505-9728

Provider Enumeration Date	:	10/07/2022
Last Update Date	:	06/10/2024

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