Provider Demographics
NPI:1477611259
Name:ESSEX PODIATRY ASSOCIATES
Entity Type:Organization
Organization Name:ESSEX PODIATRY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-762-9060
Mailing Address - Street 1:22 OLD SHORT HILLS RD STE 214
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5612
Mailing Address - Country:US
Mailing Address - Phone:973-535-9060
Mailing Address - Fax:973-535-9062
Practice Address - Street 1:22 OLD SHORT HILLS RD STE 214
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5612
Practice Address - Country:US
Practice Address - Phone:973-535-9060
Practice Address - Fax:973-535-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT77741Medicare UPIN
NJT77739Medicare UPIN