NPIMap

Organization Active NPI

LDDL Surgical Podiatry Associates

  • Foot & Ankle Surgery Podiatrist
  • South Amboy, NJ
National Provider Identifier
1629369996
Registry record updated Apr 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
25MD00307600 Issued in NJ
Legal business name
LDDL SURGICAL PODIATRY ASSOCIATES
Practice address
20 Vermeer Dr
Apt 11
South Amboy, NJ 08879-2339
Phone
(732) 709-3405
NPI assigned
Apr 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2011

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

Authorized official

Name
Dr. Leo Davidson, DPM
Title
Owner
Phone
(732) 709-3405

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 25MD00307600 NJ Primary

Addresses

Primary practice location

20 Vermeer Dr
Apt 11
South Amboy, NJ 08879-2339

Mailing address

20 Vermeer Dr
Apt 11
South Amboy, NJ 08879-2339
Phone (732) 709-3405

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1629369996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 VERMEER DR",
            "address_2": "APT 11",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792339",
            "telephone_number": "732-709-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 VERMEER DR",
            "address_2": "APT 11",
            "city": "SOUTH AMBOY",
            "state": "NJ",
            "postal_code": "088792339",
            "telephone_number": "732-709-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LDDL SURGICAL PODIATRY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "LEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-709-3405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00307600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.