Provider Demographics
NPI:1770116816
Name:FOOT & ANKLE CENTER OF SJ
Entity type:Organization
Organization Name:FOOT & ANKLE CENTER OF SJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAMIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-567-0606
Mailing Address - Street 1:750 S WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2000
Mailing Address - Country:US
Mailing Address - Phone:609-567-0606
Mailing Address - Fax:609-567-2509
Practice Address - Street 1:750 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2000
Practice Address - Country:US
Practice Address - Phone:609-567-0606
Practice Address - Fax:609-567-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-18
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty