Provider Demographics
NPI:1285403709
Name:DALAL DADHANIA ANCILLARY SERVICES
Entity type:Organization
Organization Name:DALAL DADHANIA ANCILLARY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VRUNDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DALAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:551-482-0671
Mailing Address - Street 1:801 ROUTE 73 N STE B
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1283
Mailing Address - Country:US
Mailing Address - Phone:856-831-7700
Mailing Address - Fax:
Practice Address - Street 1:801 ROUTE 73 N STE B
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1283
Practice Address - Country:US
Practice Address - Phone:856-831-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric