Provider Demographics
NPI:1568860872
Name:PROMPT PODIATRY, LLC
Entity Type:Organization
Organization Name:PROMPT PODIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VITO
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRUZZELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-872-1544
Mailing Address - Street 1:710 SOMERSET ST
Mailing Address - Street 2:
Mailing Address - City:WATCHUNG
Mailing Address - State:NJ
Mailing Address - Zip Code:07069-4941
Mailing Address - Country:US
Mailing Address - Phone:908-872-1544
Mailing Address - Fax:
Practice Address - Street 1:710 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-4941
Practice Address - Country:US
Practice Address - Phone:908-872-1544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00153700213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty