Provider Demographics
NPI:1154079762
Name:A1 FOOT AND ANKLE CARE PC
Entity Type:Organization
Organization Name:A1 FOOT AND ANKLE CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AAKRUTI
Authorized Official - Middle Name:
Authorized Official - Last Name:BHALJA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:323-213-6687
Mailing Address - Street 1:222 WORTH ST
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-2909
Mailing Address - Country:US
Mailing Address - Phone:732-321-3668
Mailing Address - Fax:732-321-0400
Practice Address - Street 1:222 WORTH ST
Practice Address - Street 2:
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2909
Practice Address - Country:US
Practice Address - Phone:732-321-3668
Practice Address - Fax:732-321-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-13
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0639435Medicaid