Provider Demographics
NPI:1679969471
Name:COMPLETE FOOT AND ANKLE CARE
Entity Type:Organization
Organization Name:COMPLETE FOOT AND ANKLE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:FITTANTO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-839-1003
Mailing Address - Street 1:257 MONMOUTH RD
Mailing Address - Street 2:BUILDING B SUITE 5
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1500
Mailing Address - Country:US
Mailing Address - Phone:973-839-1003
Mailing Address - Fax:973-839-3653
Practice Address - Street 1:257 MONMOUTH RD
Practice Address - Street 2:BUILDING B SUITE 5
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1500
Practice Address - Country:US
Practice Address - Phone:973-839-1003
Practice Address - Fax:973-839-3653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00194000213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty