Provider Demographics
NPI:1083837041
Name:FAMILY FOOT HEALTH CENTER, P.C.
Entity Type:Organization
Organization Name:FAMILY FOOT HEALTH CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LESSER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-370-1100
Mailing Address - Street 1:4527 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3380
Mailing Address - Country:US
Mailing Address - Phone:732-370-1100
Mailing Address - Fax:
Practice Address - Street 1:4527 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3380
Practice Address - Country:US
Practice Address - Phone:732-370-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD01230213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0609660001Medicare NSC
NJT73093Medicare UPIN
NJ083885Medicare PIN