Organization
OLD HOOK PODIATRY ASSOC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN E DOERNER (BILLING MANAGER)
(201) 391-6731
Entity
Organization
Contact information
Practice address
452 OLD HOOK RD, 2ND FL, EMERSON, NJ 07630-1381
(201) 599-1336
(201) 599-1386
Mailing address
452 OLD HOOK RD, 2ND FL, EMERSON, NJ 07630-1381
(201) 599-1336
(201) 599-1386
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
25MD00273200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075902
MEDICARE GROUP PIN
NJ
Enumeration date
11/13/2006
Last updated
08/12/2008
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