Organization
GARDEN STATE PODIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. UJJWAL KUMAR DATTA DPM (OWNER)
(732) 537-9200
Entity
Organization
Contact information
Practice address
4 E HIGH ST, BOUND BROOK, NJ 08805-1946
(732) 537-9200
(732) 356-3750
Mailing address
4 E HIGH ST, BOUND BROOK, NJ 08805-1946
(732) 537-9200
(732) 356-3750
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NJ
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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