Provider Demographics
NPI:1083007736
Name:RIVERVIEW FOOT & ANKLE ASSOCIATES, PC
Entity Type:Organization
Organization Name:RIVERVIEW FOOT & ANKLE ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEITCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-747-2111
Mailing Address - Street 1:130 MAPLE AVE
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1734
Mailing Address - Country:US
Mailing Address - Phone:732-747-2111
Mailing Address - Fax:732-530-1348
Practice Address - Street 1:312 APPLEGARTH RD
Practice Address - Street 2:207
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-5347
Practice Address - Country:US
Practice Address - Phone:609-409-8381
Practice Address - Fax:609-409-6891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty