Provider Demographics
NPI:1649060195
Name:FOOT CARE CLINIC INC
Entity type:Organization
Organization Name:FOOT CARE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MITUL
Authorized Official - Middle Name:
Authorized Official - Last Name:AJVALIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-518-1450
Mailing Address - Street 1:31 S HALL CT
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4369
Mailing Address - Country:US
Mailing Address - Phone:973-518-1450
Mailing Address - Fax:
Practice Address - Street 1:171 RIDGEDALE AVE STE F
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1764
Practice Address - Country:US
Practice Address - Phone:973-518-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty