Provider Demographics
NPI:1083706386
Name:FORT LEE FOOT AND ANKLE CENTER PC
Entity Type:Organization
Organization Name:FORT LEE FOOT AND ANKLE CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:VOVCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-947-1758
Mailing Address - Street 1:162 SIERRA VISTA LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2702
Mailing Address - Country:US
Mailing Address - Phone:845-480-2018
Mailing Address - Fax:201-947-4555
Practice Address - Street 1:2247 LEMOINE AVE
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-6124
Practice Address - Country:US
Practice Address - Phone:201-947-1758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00275000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty