Provider Demographics
NPI:1659475929
Name:ADVANCED FOOT ANKLE SURGEONS CORP
Entity Type:Organization
Organization Name:ADVANCED FOOT ANKLE SURGEONS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-285-1700
Mailing Address - Street 1:PO BOX 513
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-0513
Mailing Address - Country:US
Mailing Address - Phone:973-285-1700
Mailing Address - Fax:973-538-9478
Practice Address - Street 1:1 ANDERSON HILL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2350
Practice Address - Country:US
Practice Address - Phone:973-285-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty