Organization
FOOTPRINTS MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUYIWA AKIN OKURIBIDO SR. DPM (DIRECTOR)
(908) 355-4365
Entity
Organization
Contact information
Practice address
163 NORTH AVE, HILLSIDE, NJ 07205-3125
(908) 355-4365
(856) 504-0200
Mailing address
163 NORTH AVENUE, HILLSIDE, NJ 07205
(908) 355-4365
(856) 504-0200
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD2566
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8442207
—
NJ
Enumeration date
05/26/2011
Last updated
05/26/2011
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