Provider Demographics
NPI:1801891361
Name:KANOFF, BARRY (DPM)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:KANOFF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 COLUMBIA TPKE
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2106
Mailing Address - Country:US
Mailing Address - Phone:973-514-2000
Mailing Address - Fax:973-514-1114
Practice Address - Street 1:118 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2106
Practice Address - Country:US
Practice Address - Phone:973-514-2000
Practice Address - Fax:973-514-1114
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD000869213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T-82439Medicare UPIN
NJ451214Medicare ID - Type Unspecified