Organization
FOOT CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERA KHRAKOVSKY DPM (OWNER)
(908) 687-3343
Entity
Organization
Contact information
Practice address
2565 MORRIS AVE, UNION, NJ 07083-5613
(908) 687-3343
(908) 687-3343
Mailing address
2565 MORRIS AVE, UNION, NJ 07083-5613
(908) 687-3343
(908) 687-3343
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
MD001942
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161791
MEDICARE ID
NJ
05
—
1928007
—
NJ
Enumeration date
06/19/2007
Last updated
01/15/2008
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