Bergen Reconstructive Foot & Ankle Specialists LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

BERGEN RECONSTRUCTIVE FOOT & ANKLE SPECIALISTS LLC

Practice address

315 Rochelle Ave
Rochelle Park, NJ 07662-3916

Phone

(201) 414-8089

Fax

(201) 843-1036

NPI assigned

Nov 5, 2020

Last updated

Nov 5, 2020By 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

Daniella Renee Menillo, DPM

Title

Owner

Phone

(201) 414-8089

Specialties & licenses 1

Addresses

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.

• Steven Menillo, DDS

  • General Practice Dentistry
  • Rochelle Park, NJ
  • NPI 1629195680
  NPD (past)

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1922609916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ROCHELLE AVE",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076623916",
            "telephone_number": "201-414-8089",
            "fax_number": "201-843-1036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ROCHELLE AVE",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076623916",
            "telephone_number": "201-414-8089",
            "fax_number": "201-843-1036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN RECONSTRUCTIVE FOOT & ANKLE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "MENILLO",
        "authorized_official_first_name": "DANIELLA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-414-8089",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Rochelle Park, NJ
• Providers in Rochelle Park, 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 Nov 5, 2020; 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.