Provider Demographics
NPI:1386931889
Name:TOTAL CARE PODIATRY, LLC
Entity type:Organization
Organization Name:TOTAL CARE PODIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-513-6719
Mailing Address - Street 1:4122 ROUTE 516
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-7022
Mailing Address - Country:US
Mailing Address - Phone:718-513-6719
Mailing Address - Fax:718-513-6721
Practice Address - Street 1:4122 ROUTE 516
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747-7022
Practice Address - Country:US
Practice Address - Phone:718-513-6719
Practice Address - Fax:718-513-6721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00307700213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty