Organization
JERSEY SHORE FOOT AND LEG CENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KATHY MUHLHAUSEN (OFFICE MANAGER)
(908) 769-5337
Entity
Organization
Contact information
Practice address
10 SHAWNEE DR, WATCHUNG, NJ 07069-5803
(908) 769-5337
Mailing address
10 SHAWNEE DR, WATCHUNG, NJ 07069-5803
(908) 769-5337
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
MD1954
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679589261
HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY
NJ
Enumeration date
08/15/2008
Last updated
08/15/2008
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