Organization
ADVANCED FOOT CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH ANTHONY MEGARA III DPM (MANAGING MEMEBER)
(856) 579-8674
Entity
Organization
Contact information
Practice address
204 GROVE AVE, SUITE G, THOROFARE, NJ 08086-2557
(856) 579-8674
(856) 579-8676
Mailing address
204 GROVE AVE, SUITE G, THOROFARE, NJ 08086-2557
(856) 579-8674
(856) 579-8676
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00273100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240449
MEDICARE PTAN
NJ
Enumeration date
01/05/2011
Last updated
10/17/2012
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