Provider Demographics
NPI:1790727485
Name:FOOT AND ANKLE SPECIALISTS OF NY AND NJ LLC
Entity Type:Organization
Organization Name:FOOT AND ANKLE SPECIALISTS OF NY AND NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCKMORE
Authorized Official - Suffix:
Authorized Official - Credentials:D P M
Authorized Official - Phone:609-585-0500
Mailing Address - Street 1:1230 WHITEHORSE MERCERVILLE RD STE C
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3838
Mailing Address - Country:US
Mailing Address - Phone:609-585-0500
Mailing Address - Fax:609-585-5975
Practice Address - Street 1:1230 WHITEHORSE MERCERVILLE RD STE C
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3838
Practice Address - Country:US
Practice Address - Phone:609-585-0500
Practice Address - Fax:609-585-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD002526000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0595923OtherAETNA PPO
NJ2116245000OtherAMERIHEALTH
NJ7987909Medicaid
NJ1167937OtherNJ HEALTH
NJ192566OtherAMERIHEALTH PC
NJ2K4955OtherHEALTHNET
NJU73662Medicare UPIN
NJ2K4955OtherHEALTHNET
NJ1167937OtherNJ HEALTH