Provider Demographics
NPI:1497816151
Name:STUART W. HONICK, D.P.M., P.T., LLC
Entity Type:Organization
Organization Name:STUART W. HONICK, D.P.M., P.T., LLC
Other - Org Name:GO FEET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:HONICK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:609-704-9001
Mailing Address - Street 1:8 N WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1873
Mailing Address - Country:US
Mailing Address - Phone:609-704-9001
Mailing Address - Fax:609-704-8316
Practice Address - Street 1:8 N WHITE HORSE PIKE
Practice Address - Street 2:SUITE 103
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1873
Practice Address - Country:US
Practice Address - Phone:609-704-9001
Practice Address - Fax:609-704-8316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00228000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6471005Medicaid
NJ4703770001Medicare NSC
NJ778208Medicare ID - Type Unspecified
NJU56575Medicare UPIN