Provider Demographics
NPI:1760484828
Name:OCEAN COUNTY FOOT & ANKLE SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:OCEAN COUNTY FOOT & ANKLE SURGICAL ASSOCIATES
Other - Org Name:OCEAN COUNTY FOOT & ANKLE SURGICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-505-9728
Mailing Address - Street 1:54 BEY LEA RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2978
Mailing Address - Country:US
Mailing Address - Phone:732-505-9728
Mailing Address - Fax:732-505-9787
Practice Address - Street 1:54 BEY LEA RD
Practice Address - Street 2:SUITE 1
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2978
Practice Address - Country:US
Practice Address - Phone:732-505-9728
Practice Address - Fax:732-505-9787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7000103Medicaid
NJ7000103Medicaid
1119700001Medicare NSC