# DR DINA IBRAHIM FOOT & ANKLE SURGERY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619595659
- **Authorized official:** DEREK MERCER (CREDENTIALING EXECUTIVE)
- **Authorized official phone:** (718) 841-7318

## Contact information

- **Practice address:** 7600 RIVER RD, NORTH BERGEN, NJ 07047-6217
- **Practice address phone:** (973) 870-0777
- **Mailing address:** 11 HUMPHREY AVE, BAYONNE, NJ 07002-7311

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 07/07/2020
- **Last updated:** 04/13/2021