Provider Demographics
NPI:1558595652
Name:JON I.HELLER ,INC
Entity Type:Organization
Organization Name:JON I.HELLER ,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:I
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-389-9000
Mailing Address - Street 1:384 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2561
Mailing Address - Country:US
Mailing Address - Phone:973-389-9000
Mailing Address - Fax:
Practice Address - Street 1:384 UNION BLVD
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2561
Practice Address - Country:US
Practice Address - Phone:973-389-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-05
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7637306Medicaid
NJ7637306Medicaid
NJ527270Medicare PIN