Provider Demographics
NPI:1740887033
Name:FAVOR FOOT AND ANKLE PODIATRY PC
Entity type:Organization
Organization Name:FAVOR FOOT AND ANKLE PODIATRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:844-777-8700
Mailing Address - Street 1:100 HORIZON CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-1910
Mailing Address - Country:US
Mailing Address - Phone:844-777-8700
Mailing Address - Fax:917-791-9755
Practice Address - Street 1:100 HORIZON CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-1910
Practice Address - Country:US
Practice Address - Phone:844-777-8700
Practice Address - Fax:917-791-9755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty