Provider Demographics
NPI:1780854125
Name:FOOT AND ANKLE TREATMENT CENTER PC PC
Entity Type:Organization
Organization Name:FOOT AND ANKLE TREATMENT CENTER PC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIFITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-262-4770
Mailing Address - Street 1:241 ORADELL AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4808
Mailing Address - Country:US
Mailing Address - Phone:201-262-4770
Mailing Address - Fax:
Practice Address - Street 1:241 ORADELL AVE
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4808
Practice Address - Country:US
Practice Address - Phone:201-262-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1324403Medicaid
4025200001Medicare NSC