Provider Demographics
NPI:1639142730
Name:FOOT CARE ASSOCIATES P.C.
Entity Type:Organization
Organization Name:FOOT CARE ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOLITERNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-852-0229
Mailing Address - Street 1:488 SCHOOLEYS MTN RD
Mailing Address - Street 2:HASTINGS COMMONS BLDG. 1B
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4001
Mailing Address - Country:US
Mailing Address - Phone:908-852-0229
Mailing Address - Fax:908-852-1076
Practice Address - Street 1:488 SCHOOLEYS MTN RD
Practice Address - Street 2:HASTINGS COMMONS BLDG. 1B
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4001
Practice Address - Country:US
Practice Address - Phone:908-852-0229
Practice Address - Fax:908-852-1076
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOOT CARE ASSOCIATES P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-09
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00171800213E00000X
NJ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ896177Medicare ID - Type UnspecifiedMEDICARE GROUP ID
NJ4066020001Medicare NSC