Provider Demographics
NPI:1992865141
Name:EPSTEIN, WAYNE (DPM)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 ST. GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067
Mailing Address - Country:US
Mailing Address - Phone:732-636-2877
Mailing Address - Fax:732-636-7418
Practice Address - Street 1:1009 ST. GEORGES AVE
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067
Practice Address - Country:US
Practice Address - Phone:732-636-2877
Practice Address - Fax:732-636-7418
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD001997213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU16858Medicare UPIN
NJEP648639Medicare ID - Type Unspecified