Provider Demographics
NPI:1679505911
Name:TZORFAS, HOWARD J (DPM)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:J
Last Name:TZORFAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 555
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NJ
Mailing Address - Zip Code:08833-0555
Mailing Address - Country:US
Mailing Address - Phone:908-236-6999
Mailing Address - Fax:908-236-0694
Practice Address - Street 1:1386 ROUTE 22 WEST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NJ
Practice Address - Zip Code:08833
Practice Address - Country:US
Practice Address - Phone:908-236-6999
Practice Address - Fax:908-236-0694
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00173200213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223039166OtherTAX ID
NJ2015307Medicaid
NJ223039166OtherTAX ID
NJ1050640001Medicare NSC
NJT77744Medicare UPIN