Provider Demographics
NPI:1831210517
Name:NEW JERSEY FOOT AND ANKLE ASSOCIATES LLC
Entity type:Organization
Organization Name:NEW JERSEY FOOT AND ANKLE ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANNELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, FACFAS
Authorized Official - Phone:732-821-2400
Mailing Address - Street 1:2050 STATE ROUTE 27
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1380
Mailing Address - Country:US
Mailing Address - Phone:732-821-2400
Mailing Address - Fax:732-821-2426
Practice Address - Street 1:2050 STATE ROUTE 27
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1380
Practice Address - Country:US
Practice Address - Phone:732-821-2400
Practice Address - Fax:732-821-2426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00231900213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ808479Medicare ID - Type UnspecifiedROBERT ZANNELLA
NJU74736Medicare UPIN
NJ4503280001Medicare NSC
NJU61112Medicare UPIN