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Organization

ACTIVE PODIATRY LLC

Active
Other names
Active Podiatry LLC
Organization subpart
No

Provider details

NPI number
Authorized official
HOMAM BADRI DPM (DPM)
(201) 614-3668
Entity
Organization

Contact information

Practice address
2035 HAMBURG TPKE STE B, WAYNE, NJ 07470-6251
(201) 614-3668
(973) 256-4757
Mailing address
2035 HAMBURG TPKE STE B, WAYNE, NJ 07470-6251
(201) 614-3668
(973) 256-4757

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD0032100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0429732
NJ
Enumeration date
02/28/2018
Last updated
09/02/2025
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