Provider Demographics
NPI:1326422460
Name:JERSEY FOOT AND ANKLE
Entity Type:Organization
Organization Name:JERSEY FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIEZER
Authorized Official - Middle Name:
Authorized Official - Last Name:EISENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-481-0272
Mailing Address - Street 1:155 RECTOR COURT
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:212-569-5701
Practice Address - Street 1:155 RECTOR CT
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-4225
Practice Address - Country:US
Practice Address - Phone:845-481-0272
Practice Address - Fax:212-569-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2015-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty