Organization
ANKLE & FOOT SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN PETER LICOPANTIS DPM (PODIATRIST)
(973) 331-7900
Entity
Organization
Contact information
Practice address
16 POCONO RD, SUITE 209, DENVILLE, NJ 07834-2901
(973) 331-7900
(973) 331-7999
Mailing address
16 POCONO RD, SUITE 209, DENVILLE, NJ 07834-2901
(973) 331-7900
(973) 331-7999
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00187700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0943908
—
NJ
Enumeration date
05/30/2008
Last updated
11/04/2014
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