Provider Demographics
NPI:1306868302
Name:BIEBEL & DECOTIIS ASSOCIATES, LLC
Entity Type:Organization
Organization Name:BIEBEL & DECOTIIS ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BIEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-888-1717
Mailing Address - Street 1:721 N BEERS ST
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1518
Mailing Address - Country:US
Mailing Address - Phone:732-888-1717
Mailing Address - Fax:732-888-2101
Practice Address - Street 1:721 N BEERS ST
Practice Address - Street 2:SUITE 2C
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1518
Practice Address - Country:US
Practice Address - Phone:732-888-1717
Practice Address - Fax:732-888-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD01539213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0036137Medicaid
2298183000OtherAMERIHEALTH GR.PROV. #
NJ081577Medicare ID - Type UnspecifiedGROUP NUMBER
2298183000OtherAMERIHEALTH GR.PROV. #