Provider Demographics
NPI:1285032029
Name:ENGLEWOOD FOOT AND ANKLE ASSOCIATES PC
Entity Type:Organization
Organization Name:ENGLEWOOD FOOT AND ANKLE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEMETRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ECONOPOULY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-863-5383
Mailing Address - Street 1:25 ROCKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4957
Mailing Address - Country:US
Mailing Address - Phone:201-863-5383
Mailing Address - Fax:201-863-3055
Practice Address - Street 1:1906 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-2294
Practice Address - Country:US
Practice Address - Phone:201-863-5383
Practice Address - Fax:201-863-3055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00208800261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical