Provider Demographics
NPI:1790491520
Name:FOOT AND ANKLE PHYSICIANS OF NJ, LLC
Entity Type:Organization
Organization Name:FOOT AND ANKLE PHYSICIANS OF NJ, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LONGOBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-258-0111
Mailing Address - Street 1:100 MORRIS AVE STE 304
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1423
Mailing Address - Country:US
Mailing Address - Phone:973-258-0111
Mailing Address - Fax:973-258-0123
Practice Address - Street 1:290 MADISON AVE BLD 5
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960
Practice Address - Country:US
Practice Address - Phone:973-397-9600
Practice Address - Fax:973-397-9602
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOOT AND ANKLE PHYSICIANS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-25
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty