Garden State Podiatry, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

GARDEN STATE PODIATRY, LLC

Practice address

4 E High St
Bound Brook, NJ 08805-1946

Phone

(732) 537-9200

Fax

(732) 356-3750

NPI assigned

May 3, 2012

Last updated

May 3, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ujjwal Kumar Datta, DPMNPI 1760486385

Title

Owner

Phone

(732) 537-9200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ujjwal Kumar Datta, DPM

  • Foot Surgery Podiatrist
  • Bound Brook, NJ
  • NPI 1760486385
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336003200000",
    "number": "1194084640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 E HIGH ST",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051946",
            "telephone_number": "732-537-9200",
            "fax_number": "732-356-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 E HIGH ST",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051946",
            "telephone_number": "732-537-9200",
            "fax_number": "732-356-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE PODIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-03",
        "last_updated": "2012-05-03",
        "status": "A",
        "authorized_official_last_name": "DATTA",
        "authorized_official_first_name": "UJJWAL",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-537-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blanche L Frazier
• Patricia Freyberger, LCSW
• Ella Friedman, M.D.
• Yoram Saul Friedman, O.D.
• Sriranjani Ganesan
• Arya Ghandeharizadeh, DMD
• Frieda Goldman, MD
• Paul Bennet Goldstein, D.C.
• Green Valley Medical Equipment
• Green Valley Medical Equipment (Green Valley Pharmacy)

• Foot & Ankle Surgery Podiatrist in Bound Brook, NJ
• Providers in Bound Brook, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.