Individual
DR. LARRY M NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
344 LAFAYETTE AVE, HAWTHORNE, NJ 07506-2506
(973) 238-0660
(973) 238-1003
Mailing address
344 LAFAYETTE AVE, HAWTHORNE, NJ 07506-2506
(973) 238-0660
(973) 238-1003
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD002180
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5423902
—
NJ
01
—
P3602754
OXFORD
NJ
01
—
PA000000100
AMERICHOICE
NJ
Enumeration date
03/10/2006
Last updated
02/01/2010
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