Provider Demographics
NPI:1487827192
Name:MORRIS PODIATRY ASSOCIATES, PA
Entity Type:Organization
Organization Name:MORRIS PODIATRY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-584-4600
Mailing Address - Street 1:66 SUNSET STRIP
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1345
Mailing Address - Country:US
Mailing Address - Phone:973-584-4600
Mailing Address - Fax:973-584-9359
Practice Address - Street 1:255 ROUTE 3 EAST
Practice Address - Street 2:SUITE 107
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094
Practice Address - Country:US
Practice Address - Phone:201-863-7460
Practice Address - Fax:201-863-7525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5611202Medicaid
720252Medicare PIN
0716360004Medicare NSC