Provider Demographics
NPI:1427280486
Name:JOHN F CONNORS DPM & ASSOCIATES, L.L.C
Entity type:Organization
Organization Name:JOHN F CONNORS DPM & ASSOCIATES, L.L.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:STACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-741-2300
Mailing Address - Street 1:200 WHITE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1150
Mailing Address - Country:US
Mailing Address - Phone:732-741-2300
Mailing Address - Fax:732-741-0469
Practice Address - Street 1:200 WHITE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1150
Practice Address - Country:US
Practice Address - Phone:732-741-2300
Practice Address - Fax:732-741-0469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00180600213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ536499Medicare UPIN