Provider Demographics
NPI:1518183631
Name:FEET N BEYOND OF NEW JERSEY PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:FEET N BEYOND OF NEW JERSEY PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-576-0880
Mailing Address - Street 1:188 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2412
Mailing Address - Country:US
Mailing Address - Phone:908-576-0880
Mailing Address - Fax:908-576-0881
Practice Address - Street 1:188 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2412
Practice Address - Country:US
Practice Address - Phone:908-576-0880
Practice Address - Fax:908-576-0881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ70165Medicaid
6635030001Medicare NSC
NJ111270Medicare PIN