Provider Demographics
NPI:1699716134
Name:PODIATRY- FOOT AND ANKLE SURGERY ASSOCIATES,P.C.
Entity type:Organization
Organization Name:PODIATRY- FOOT AND ANKLE SURGERY ASSOCIATES,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:N
Authorized Official - Last Name:MEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-426-6667
Mailing Address - Street 1:151 E PALISADE AVE
Mailing Address - Street 2:APT C12
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2248
Mailing Address - Country:US
Mailing Address - Phone:845-426-6667
Mailing Address - Fax:201-503-0399
Practice Address - Street 1:151 EAST PALISADE AV. APT C12
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-2255
Practice Address - Country:US
Practice Address - Phone:201-503-0399
Practice Address - Fax:201-503-0399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01596336Medicaid
NJ8680809Medicaid
NYPWW481Medicare ID - Type Unspecified
NY01596336Medicaid
NJ8680809Medicaid
NYU58334Medicare UPIN