Organization
JERSEY FOOT AND ANKLE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRIETTA I OBIDIGBO DPM (OWNER)
(973) 216-9071
Entity
Organization
Contact information
Practice address
152 MARKET ST, SUITE 314, PATERSON, NJ 07505-1724
(973) 278-4200
Mailing address
152 MARKET ST, SUITE 314, PATERSON, NJ 07505-1724
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00296100
NJ
Other
Enumeration date
03/28/2011
Last updated
01/19/2012
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