Provider Demographics
NPI:1881982197
Name:BELANGER PODIATRY ASSOCIATES, LLC
Entity type:Organization
Organization Name:BELANGER PODIATRY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BELANGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-489-7357
Mailing Address - Street 1:1806 STATE ROUTE 35 STE 103
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2766
Mailing Address - Country:US
Mailing Address - Phone:732-643-5500
Mailing Address - Fax:732-869-4522
Practice Address - Street 1:1806 STATE ROUTE 35 STE 103
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2766
Practice Address - Country:US
Practice Address - Phone:732-643-5500
Practice Address - Fax:732-869-4522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00253200213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ043113OtherMEDICARE
NJ9112707Medicaid
NJ043113OtherMEDICARE
NJU75778Medicare PIN