Provider Demographics
NPI:1659455848
Name:HOBOKEN ANKLE & FOOT CENTER
Entity Type:Organization
Organization Name:HOBOKEN ANKLE & FOOT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:LIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-656-4608
Mailing Address - Street 1:500 BLOOMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030
Mailing Address - Country:US
Mailing Address - Phone:201-656-4608
Mailing Address - Fax:201-656-4633
Practice Address - Street 1:500 BLOOMFIELD ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030
Practice Address - Country:US
Practice Address - Phone:201-656-4608
Practice Address - Fax:201-656-4633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD2482213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7842902Medicaid
NJ017755MYKMedicare ID - Type Unspecified
U61721Medicare UPIN
NJ4055310001Medicare NSC