Provider Demographics
NPI:1912911710
Name:KBF FOOT AND ANKLE SURGEONS PA
Entity Type:Organization
Organization Name:KBF FOOT AND ANKLE SURGEONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY KBF FOOT AND ANKLE SURGEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-465-1717
Mailing Address - Street 1:114 W MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2932
Mailing Address - Country:US
Mailing Address - Phone:973-994-2323
Mailing Address - Fax:973-994-1970
Practice Address - Street 1:114 W MOUNT PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-2932
Practice Address - Country:US
Practice Address - Phone:973-994-2323
Practice Address - Fax:973-994-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00216600213E00000X
NJ25MD00206300213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3096203Medicaid
NJ3096203Medicaid
U46137Medicare UPIN
NJ1150840001Medicare NSC
NJ812147Medicare PIN