Organization
DOVER FOOT CARE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY IVANOVS D.P.M. (OWNER)
(973) 366-8000
Entity
Organization
Contact information
Practice address
387 W BLACKWELL ST, DOVER, NJ 07801-2520
(973) 366-8000
(973) 442-1300
Mailing address
387 W BLACKWELL ST, DOVER, NJ 07801-2520
(973) 366-8000
(973) 442-1300
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
MD01886
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NJ
Enumeration date
01/03/2007
Last updated
04/22/2009
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