Provider Demographics
NPI:1770973703
Name:PERFECT STEPS CARE CENTER, INC.
Entity type:Organization
Organization Name:PERFECT STEPS CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VASTHY
Authorized Official - Middle Name:T
Authorized Official - Last Name:JEAN-LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:347-770-9900
Mailing Address - Street 1:579B RARITAN RD
Mailing Address - Street 2:SUITE 186
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-2473
Mailing Address - Country:US
Mailing Address - Phone:973-388-6300
Mailing Address - Fax:888-896-1997
Practice Address - Street 1:455 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-2605
Practice Address - Country:US
Practice Address - Phone:973-388-6300
Practice Address - Fax:888-896-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00293100213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ118964W93OtherMEDICARE INDVIDUAL PTAN
NJ118964W93OtherMEDICARE GROUP PTAN