Provider Demographics
NPI:1487102778
Name:CORNERSTONE FOOT & ANKLE
Entity type:Organization
Organization Name:CORNERSTONE FOOT & ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WARKALA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-582-6082
Mailing Address - Street 1:516 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOLLY
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-1026
Mailing Address - Country:US
Mailing Address - Phone:856-582-6082
Mailing Address - Fax:856-582-0683
Practice Address - Street 1:707 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1605
Practice Address - Country:US
Practice Address - Phone:856-582-6082
Practice Address - Fax:856-582-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty