Provider Demographics
NPI:1013233691
Name:J. CHRISTOPHER CONNOR, D.P.M., P.A
Entity Type:Organization
Organization Name:J. CHRISTOPHER CONNOR, D.P.M., P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-589-0401
Mailing Address - Street 1:427 EGG HARBOR RD
Mailing Address - Street 2:
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-9208
Mailing Address - Country:US
Mailing Address - Phone:856-589-0401
Mailing Address - Fax:856-589-6682
Practice Address - Street 1:427 EGG HARBOR RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9208
Practice Address - Country:US
Practice Address - Phone:856-589-0401
Practice Address - Fax:856-589-6682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00104300213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3045803Medicaid
NJ0248750001Medicare NSC
NJT44639Medicare UPIN
176607Medicare PIN