Provider Demographics
NPI:1588609846
Name:WOOMER, FAY (DPM)
Entity Type:Individual
Prefix:
First Name:FAY
Middle Name:
Last Name:WOOMER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 FOREST AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-5410
Mailing Address - Country:US
Mailing Address - Phone:201-986-1881
Mailing Address - Fax:201-986-1871
Practice Address - Street 1:277 FOREST AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-5410
Practice Address - Country:US
Practice Address - Phone:201-986-1881
Practice Address - Fax:201-986-1871
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD02098213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U24384Medicare UPIN
NJ697682ABFMedicare ID - Type Unspecified