Provider Demographics
NPI:1598735631
Name:ANANIA, WILLIAM CHRISTIAN SR (DPM, PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHRISTIAN
Last Name:ANANIA
Suffix:SR
Gender:M
Credentials:DPM, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 TINDALL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-2337
Mailing Address - Country:US
Mailing Address - Phone:732-671-3939
Mailing Address - Fax:732-671-4799
Practice Address - Street 1:112 TINDALL RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2337
Practice Address - Country:US
Practice Address - Phone:732-671-3939
Practice Address - Fax:732-671-4799
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00157600213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3340406Medicaid
NJ3340406Medicaid
NJ134060Medicare ID - Type UnspecifiedMEDICARE