Organization
MEDFORD FOOT SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA L KOWALEWSKI (BILLING MANAGER)
(856) 753-0913
Entity
Organization
Contact information
Practice address
128 ROUTE 70, SUITE 14, MEDFORD, NJ 08055-2371
(609) 714-3434
(609) 714-1933
Mailing address
128 ROUTE 70, SUITE 14, MEDFORD, NJ 08055-2371
(609) 714-3434
(609) 714-1933
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7899700
—
NJ
Enumeration date
12/08/2006
Last updated
06/02/2008
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