Organization
ESTRADA PODIATRY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER ESTRADA DPM (PRESIDENT)
(201) 865-3400
Entity
Organization
Contact information
Practice address
5005 BERGENLINE AVE, WEST NEW YORK, NJ 07093-5563
(201) 865-3400
(201) 520-0040
Mailing address
5005 BERGENLINE AVE, WEST NEW YORK, NJ 07093-5563
(201) 865-3400
(201) 520-0040
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00268900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0056553
—
NJ
01
—
P00353274
PALMETTO GBA
NJ
Enumeration date
05/27/2009
Last updated
05/27/2009
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