Provider Demographics
NPI:1366631194
Name:JOHN J. MCEVOY D.P.M.
Entity Type:Organization
Organization Name:JOHN J. MCEVOY D.P.M.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROP
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MCEVOY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-825-4840
Mailing Address - Street 1:294 E CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-2004
Mailing Address - Country:US
Mailing Address - Phone:201-825-4840
Mailing Address - Fax:201-825-4650
Practice Address - Street 1:294 E CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-2004
Practice Address - Country:US
Practice Address - Phone:201-825-4840
Practice Address - Fax:201-825-4650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD02487213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty