Provider Demographics
NPI:1003082835
Name:MICHAEL G KACHMAR DPM
Entity type:Organization
Organization Name:MICHAEL G KACHMAR DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:KACHMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-269-1133
Mailing Address - Street 1:355 ATLANTIC CITY BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-1292
Mailing Address - Country:US
Mailing Address - Phone:732-269-1133
Mailing Address - Fax:732-269-7675
Practice Address - Street 1:1 PELICAN DR STE 8
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-1600
Practice Address - Country:US
Practice Address - Phone:732-269-1133
Practice Address - Fax:732-269-7675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies