Provider Demographics
NPI:1972623379
Name:ANKLE AND FOOT SPECIALIST OF NJ
Entity Type:Organization
Organization Name:ANKLE AND FOOT SPECIALIST OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JYOTSNA
Authorized Official - Middle Name:
Authorized Official - Last Name:THAPAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-222-8980
Mailing Address - Street 1:908 OAK TREE AVE
Mailing Address - Street 2:SUITE R
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5100
Mailing Address - Country:US
Mailing Address - Phone:908-222-8980
Mailing Address - Fax:908-222-8976
Practice Address - Street 1:908 OAK TREE AVE
Practice Address - Street 2:SUITE R
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5100
Practice Address - Country:US
Practice Address - Phone:908-222-8980
Practice Address - Fax:908-222-8976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ082622Medicare PIN
NJ5928380001Medicare NSC