Provider Demographics
NPI:1538288725
Name:ASSOCIATED FOOT CARE OF WARREN COUNTY,PC
Entity type:Organization
Organization Name:ASSOCIATED FOOT CARE OF WARREN COUNTY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:INGRIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JANSONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-366-8000
Mailing Address - Street 1:387 WEST BLACKWELL ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-2520
Mailing Address - Country:US
Mailing Address - Phone:973-366-8000
Mailing Address - Fax:973-442-1300
Practice Address - Street 1:110 MILL ST
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2343
Practice Address - Country:US
Practice Address - Phone:908-850-0505
Practice Address - Fax:908-850-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00276200213ES0103X
NJ25MD00188600213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU94508Medicare UPIN
NJT88186Medicare UPIN