Organization
REBOOT PODIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA J KIM DPM (OWNER)
(201) 655-3565
Entity
Organization
Contact information
Practice address
72 WILLIS AVE, CRESSKILL, NJ 07626-2432
(201) 655-3565
Mailing address
246B LIVINGSTON ST STE 133, NORTHVALE, NJ 07647-1902
(201) 655-3565
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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