Provider Demographics
NPI:1710977608
Name:DAY, JAMES CHRISTOPHER JR (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:DAY
Suffix:JR
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 1:717 N BEERS ST
Mailing Address - Street 2:SUITE 1 D
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1524
Mailing Address - Country:US
Mailing Address - Phone:732-888-1003
Mailing Address - Fax:732-888-4606
Practice Address - Street 1:717 N BEERS ST
Practice Address - Street 2:SUITE 1 D
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1524
Practice Address - Country:US
Practice Address - Phone:732-888-1003
Practice Address - Fax:732-888-4606
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00107900213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1072102Medicaid
T44769Medicare UPIN
144133Medicare ID - Type Unspecified