Provider Demographics
NPI:1881773323
Name:KATES, JOEL R (DPM)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:R
Last Name:KATES
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 1:169 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850
Mailing Address - Country:US
Mailing Address - Phone:732-545-7078
Mailing Address - Fax:732-940-1837
Practice Address - Street 1:169 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:MILLTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08850
Practice Address - Country:US
Practice Address - Phone:732-545-7078
Practice Address - Fax:732-940-1837
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001377213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist