Provider Demographics
NPI:1689254161
Name:LAWRENCEVILLE FOOT AND ANKLE SPECIALISTS LLC
Entity Type:Organization
Organization Name:LAWRENCEVILLE FOOT AND ANKLE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANUP
Authorized Official - Middle Name:P
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:609-512-1126
Mailing Address - Street 1:2633 MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-1086
Mailing Address - Country:US
Mailing Address - Phone:609-512-1126
Mailing Address - Fax:609-512-1639
Practice Address - Street 1:2633 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-1086
Practice Address - Country:US
Practice Address - Phone:609-512-1126
Practice Address - Fax:609-512-1639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty