Organization
DR DINA IBRAHIM FOOT & ANKLE SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK MERCER (CREDENTIALING EXECUTIVE)
(718) 841-7318
Entity
Organization
Contact information
Practice address
7600 RIVER RD, NORTH BERGEN, NJ 07047-6217
(973) 870-0777
Mailing address
11 HUMPHREY AVE, BAYONNE, NJ 07002-7311
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
07/07/2020
Last updated
04/13/2021
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