Organization
TOMS RIVER PODIATRIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH DONOVAN DPM (OWNER)
(732) 814-7029
Entity
Organization
Contact information
Practice address
104 COMMONS WAY BLDG A, TOMS RIVER, NJ 08755-6426
(732) 349-1123
(732) 349-6549
Mailing address
104 COMMONS WAY BLDG A, TOMS RIVER, NJ 08755-6426
(732) 349-1123
(732) 349-6549
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0231622
—
NJ
Enumeration date
10/22/2021
Last updated
10/25/2021
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