Provider Demographics
NPI:1245480003
Name:ALPS ROAD FAMILY FOOT AND ANKLE
Entity type:Organization
Organization Name:ALPS ROAD FAMILY FOOT AND ANKLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GODOY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-650-5270
Mailing Address - Street 1:27 ROBIN RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1009
Mailing Address - Country:US
Mailing Address - Phone:973-650-5270
Mailing Address - Fax:201-934-7991
Practice Address - Street 1:612 ALPS RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3904
Practice Address - Country:US
Practice Address - Phone:973-650-5270
Practice Address - Fax:201-934-7991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-29
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric