Organization Active NPI

Old Hook Podiatry Assoc PC

  • Foot Surgery Podiatrist
  • Emerson, NJ
National Provider Identifier
1093886038
Registry record updated Aug 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
25MD00273200 Issued in NJ
Legal business name
OLD HOOK PODIATRY ASSOC PC
Practice address
452 Old Hook Rd
2ND FL
Emerson, NJ 07630-1381
Phone
(201) 599-1336
Fax
(201) 599-1386
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Susan E Doerner
Title
Billing Manager
Phone
(201) 391-6731

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 25MD00273200 NJ Primary

Addresses

Primary practice location

452 Old Hook Rd
2ND FL
Emerson, NJ 07630-1381

Mailing address

452 Old Hook Rd
2ND FL
Emerson, NJ 07630-1381
Phone (201) 599-1336

Other identifiers 1

IdentifierTypeStateIssuer
075902OtherNJMEDICARE GROUP PIN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1093886038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 OLD HOOK RD",
            "address_2": "2ND FL",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301381",
            "telephone_number": "201-599-1336",
            "fax_number": "201-599-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 OLD HOOK RD",
            "address_2": "2ND FL",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301381",
            "telephone_number": "201-599-1336",
            "fax_number": "201-599-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD HOOK PODIATRY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "DOERNER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "201-391-6731",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NJ",
            "license": "25MD00273200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PIN",
            "identifier": "075902",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Emerson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.