Provider Demographics
NPI:1386672020
Name:MONROE FOOT & ANKLE CARE, PC
Entity Type:Organization
Organization Name:MONROE FOOT & ANKLE CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEREL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-521-2155
Mailing Address - Street 1:15 E. RAILROAD AVE.
Mailing Address - Street 2:SUITE C
Mailing Address - City:JAMESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08831
Mailing Address - Country:US
Mailing Address - Phone:732-521-2155
Mailing Address - Fax:732-521-1687
Practice Address - Street 1:15 E. RAILROAD AVE.
Practice Address - Street 2:SUITE C
Practice Address - City:JAMESBURG
Practice Address - State:NJ
Practice Address - Zip Code:08831
Practice Address - Country:US
Practice Address - Phone:732-521-2155
Practice Address - Fax:732-521-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002235213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0953730001Medicare NSC
NJ095217Medicare ID - Type Unspecified