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Organization

CENTER FOR ADVANCED FOOT & ANKLE CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SEAN ROBERT STODDARD DPM (OWNER)
(732) 580-0566
Entity
Organization

Contact information

Practice address
1195 RT 70, UNIT 12, LAKEWOOD, NJ 08701
(732) 240-9223
(732) 370-9222
Mailing address
1195 RT 70, UNIT 12, LAKEWOOD, NJ 08701-5946
(732) 240-9223
(732) 370-9222

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00268500
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0099236
NJ
Enumeration date
06/11/2006
Last updated
06/25/2008
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