Provider Demographics
NPI:1669662375
Name:MT FEET INC
Entity Type:Organization
Organization Name:MT FEET INC
Other - Org Name:FOOT SOLUTIONS - EDISON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUNTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-321-1156
Mailing Address - Street 1:1199 AMBOY AVE
Mailing Address - Street 2:TANO MALL SUITE F5
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2552
Mailing Address - Country:US
Mailing Address - Phone:732-321-1156
Mailing Address - Fax:732-321-1157
Practice Address - Street 1:1199 AMBOY AVE
Practice Address - Street 2:TANO MALL SUITE F5
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2552
Practice Address - Country:US
Practice Address - Phone:732-321-1156
Practice Address - Fax:732-321-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-29
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5959370001Medicare NSC