Individual
JAVIER RICARDO PONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
654 MOUNT PROSPECT AVE STE 301, NEWARK, NJ 07104-3110
(973) 482-7007
(973) 482-9333
Mailing address
654 MOUNT PROSPECT AVE STE 301, NEWARK, NJ 07104-3110
(973) 482-7007
(973) 482-9333
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00246800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01000308100
AMERICHOICE OF NJ
NJ
01
—
01000308101
AMERICHOICE OF NJ
NJ
01
—
01000308102
AMERICHOICE OF NJ
NJ
01
—
01000308103
AMERICHOICE OF NJ
NJ
01
—
1135990
HORIZON NJ HEALTH
NJ
01
—
1850705
FIRST HEALTH
NJ
01
—
480030704
PALMETTO
NJ
05
—
7857004
—
NJ
01
—
P2174641
OXFORD
NJ
Enumeration date
08/22/2006
Last updated
05/09/2019
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