Provider Demographics
NPI:1881666550
Name:ADULT PEDIATRIC FOOT AND ANKLE
Entity Type:Organization
Organization Name:ADULT PEDIATRIC FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SELF PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:NAJI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWAWINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-449-0444
Mailing Address - Street 1:LAUREL AVE HWY 35
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:LAUREL AVE HWY 35
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750
Practice Address - Country:US
Practice Address - Phone:732-449-0444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25MD00274300213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU95273Medicare UPIN