Organization
BRICK FOOT & ANKLE CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MOSTAFA DPM (PHYSICIAN)
(201) 683-1133
Entity
Organization
Contact information
Practice address
292 HERBERTSVILLE RD, BRICK, NJ 08724-1734
(732) 840-8989
(732) 840-9135
Mailing address
5 ANNA ROSE CT, BORDENTOWN, NJ 08505-2270
(201) 683-1133
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598058554
1598058554
—
Enumeration date
05/26/2017
Last updated
04/16/2019
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