Provider Demographics
NPI:1578020228
Name:STEPS AHEAD PODIATRY, LLC
Entity Type:Organization
Organization Name:STEPS AHEAD PODIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:551-998-8080
Mailing Address - Street 1:199 BERGEN TPKE APT 2C
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-2341
Mailing Address - Country:US
Mailing Address - Phone:551-998-8080
Mailing Address - Fax:
Practice Address - Street 1:199 BERGEN TPKE APT 2C
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-2341
Practice Address - Country:US
Practice Address - Phone:551-998-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty