Provider Demographics
NPI:1720450737
Name:PROMPT FOOT AND ANKLE CARE LLC
Entity Type:Organization
Organization Name:PROMPT FOOT AND ANKLE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:MR
Authorized Official - First Name:VITO
Authorized Official - Middle Name:
Authorized Official - Last Name:PETRUZZELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM FACFAS
Authorized Official - Phone:201-659-5222
Mailing Address - Street 1:108 WASHINGTON ST
Mailing Address - Street 2:108 WASHINGTON ST
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4659
Mailing Address - Country:US
Mailing Address - Phone:201-659-5222
Mailing Address - Fax:201-659-0847
Practice Address - Street 1:108 WASHINGTON ST
Practice Address - Street 2:108 WASHINGTON ST
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4659
Practice Address - Country:US
Practice Address - Phone:201-659-5222
Practice Address - Fax:201-659-0847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2MD00153700213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty