Organization
PRFAA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN S SMITH JR. DPM (MANAGING PARTNER)
(609) 448-1292
Entity
Organization
Contact information
Practice address
113 MAPLE STREAM RD, SUITE 3, EAST WINDSOR, NJ 08520-2459
(609) 448-1292
(609) 448-3507
Mailing address
113 MAPLE STREAM RD, SUITE 3, EAST WINDSOR, NJ 08520-2459
(609) 448-1292
(609) 448-3507
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00135000
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
25MD00275300
NJ
213ES0103X
Foot & Ankle Surgery Podiatrist
25MD00322700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194730671
NPI
NJ
01
—
1477560910
NPI
NJ
01
—
1609127257
NPI
NJ
Enumeration date
12/21/2015
Last updated
12/21/2015
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