Provider Demographics
NPI:1982778171
Name:FOOT & ANKLE SPECIALISTS OF NJ LLC
Entity Type:Organization
Organization Name:FOOT & ANKLE SPECIALISTS OF NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:TOTTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-817-7901
Mailing Address - Street 1:40 FERRY STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105
Mailing Address - Country:US
Mailing Address - Phone:973-817-7901
Mailing Address - Fax:973-817-7447
Practice Address - Street 1:40 FERRY STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105
Practice Address - Country:US
Practice Address - Phone:973-817-7901
Practice Address - Fax:973-817-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT45702Medicare UPIN
NJ536463Medicare PIN