Provider Demographics
NPI:1316313380
Name:FOOT AND ANKLE CARE OF SOUTH JERSEY, LLC
Entity type:Organization
Organization Name:FOOT AND ANKLE CARE OF SOUTH JERSEY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, MSCB
Authorized Official - Phone:856-429-5100
Mailing Address - Street 1:100 SPRINGDALE RD
Mailing Address - Street 2:STE A3, PMB 402
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3300
Mailing Address - Country:US
Mailing Address - Phone:856-429-5100
Mailing Address - Fax:
Practice Address - Street 1:303 HADDONFIELD BERLIN RD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1412
Practice Address - Country:US
Practice Address - Phone:856-429-5100
Practice Address - Fax:856-429-5800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty