Provider Demographics
NPI:1780440826
Name:ELITE PODIATRY
Entity type:Organization
Organization Name:ELITE PODIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:ELOUZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-776-1349
Mailing Address - Street 1:406 BELMONT DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1904
Mailing Address - Country:US
Mailing Address - Phone:347-776-1349
Mailing Address - Fax:
Practice Address - Street 1:3 PLAZA DR STE 18
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-3765
Practice Address - Country:US
Practice Address - Phone:347-776-1349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports MedicineGroup - Single Specialty