Provider Demographics
NPI:1982754800
Name:CRAIG WEXLER, D.P.M. P C
Entity Type:Organization
Organization Name:CRAIG WEXLER, D.P.M. P C
Other - Org Name:WEXLER FOOT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOTTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-383-3115
Mailing Address - Street 1:125 NEWTON SPARTA RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2769
Mailing Address - Country:US
Mailing Address - Phone:973-383-3115
Mailing Address - Fax:973-383-3201
Practice Address - Street 1:125 NEWTON SPARTA RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2769
Practice Address - Country:US
Practice Address - Phone:973-383-3115
Practice Address - Fax:973-383-3201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ00201600213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1285613604OtherNPI INDIVIDUAL NUMBER
NJ0104370Medicaid
NJT81545Medicare UPIN
NJ084678Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NJ0104370Medicaid