Provider Demographics
NPI:1750568408
Name:ADULT AND CHILD FOOTCARE
Entity type:Organization
Organization Name:ADULT AND CHILD FOOTCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-255-7070
Mailing Address - Street 1:167 AVENUE AT THE CMN
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4805
Mailing Address - Country:US
Mailing Address - Phone:732-389-2555
Mailing Address - Fax:732-389-5080
Practice Address - Street 1:167 AVENUE AT THE CMN
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4805
Practice Address - Country:US
Practice Address - Phone:732-389-2555
Practice Address - Fax:732-389-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001355213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4040170001Medicare NSC
NJ045046Medicare UPIN