Provider Demographics
NPI:1679738728
Name:BUTTIGHERI FOOT CARE CENTER, P.C.
Entity Type:Organization
Organization Name:BUTTIGHERI FOOT CARE CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANDRE
Authorized Official - Last Name:BUTTIGHERI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM FACFAS
Authorized Official - Phone:201-653-7030
Mailing Address - Street 1:2761 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5515
Mailing Address - Country:US
Mailing Address - Phone:201-653-7030
Mailing Address - Fax:201-792-0576
Practice Address - Street 1:2761 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-5515
Practice Address - Country:US
Practice Address - Phone:201-653-7030
Practice Address - Fax:201-792-0576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00181700213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0693280001Medicare NSC