Provider Demographics
NPI:1184700809
Name:ASSOCIATES IN PODIATRY PA
Entity type:Organization
Organization Name:ASSOCIATES IN PODIATRY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-687-5757
Mailing Address - Street 1:318 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-1904
Mailing Address - Country:US
Mailing Address - Phone:908-687-5757
Mailing Address - Fax:908-241-1172
Practice Address - Street 1:318 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-1904
Practice Address - Country:US
Practice Address - Phone:908-687-5757
Practice Address - Fax:908-241-1172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5484250003Medicare NSC
NJ035631Medicare PIN