Provider Demographics
NPI:1497988737
Name:PODIATRY HOUSE CALLS, LLC
Entity Type:Organization
Organization Name:PODIATRY HOUSE CALLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:SLEPNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:609-822-9262
Mailing Address - Street 1:225 N GLADSTONE AVE
Mailing Address - Street 2:
Mailing Address - City:MARGATE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08402-1705
Mailing Address - Country:US
Mailing Address - Phone:609-822-9262
Mailing Address - Fax:609-289-8723
Practice Address - Street 1:225 N GLADSTONE AVE
Practice Address - Street 2:
Practice Address - City:MARGATE CITY
Practice Address - State:NJ
Practice Address - Zip Code:08402-1705
Practice Address - Country:US
Practice Address - Phone:609-822-9262
Practice Address - Fax:609-289-8723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00101000213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ119698Medicare UPIN