Provider Demographics
NPI:1598314601
Name:FAMILY FOOT & ANKLE CARE CENTER LLC
Entity Type:Organization
Organization Name:FAMILY FOOT & ANKLE CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TSOMBARIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-599-0133
Mailing Address - Street 1:119 BERKLEY RD STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08020-1161
Mailing Address - Country:US
Mailing Address - Phone:856-599-0133
Mailing Address - Fax:
Practice Address - Street 1:119 BERKLEY RD STE A
Practice Address - Street 2:
Practice Address - City:CLARKSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08020-1161
Practice Address - Country:US
Practice Address - Phone:856-599-0133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty