New Jersey Podiatric Physicians & Surgeons Group, LLC
Organization Active NPI Podiatrist · Raritan, NJ
NPI 1659953016 · NPPES record last updated Apr 26, 2021
Key facts
- NPI
- 1659953016
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- Legal business name
- NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP, LLC
- Practice address
- 575 Route 28 Ste 2107
Raritan, NJ 08869-1354 - Phone
- (908) 274-0390
- Fax
- (908) 332-5739
- NPI assigned
- Apr 26, 2021
- Organization subpart
- No
Authorized official
- Name
- Cheryl Martinetti
- Title
- Chief Operating Officer
- Phone
- (732) 994-5333
Corporate family (same tax ID) 36
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210621002394 | NJ | DME Supplier - Physician - Podiatry | 4385870153 | Practice locations: Raritan, NJ |
National Provider Directory
- Tax ID family
- New Jersey Podiatric Physicians Surgeons Group LLC
Locations
575 Route 28
Ste 2107
Raritan, NJ 08869
Phone (908) 274-0390
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | Yes |
Addresses
Primary practice location
575 Route 28 Ste 2107
Raritan, NJ 08869-1354
Mailing address
4633 Hwy 9
Howell, NJ 07731-3324
Other providers in Raritan, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.