Provider Demographics
NPI:1144077736
Name:NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP, LLC
Entity type:Organization
Organization Name:NEW JERSEY PODIATRIC PHYSICIANS & SURGEONS GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-994-5333
Mailing Address - Street 1:4633 HWY 9
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3324
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:176 ROUTE 9 STE 207
Practice Address - Street 2:
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726-9220
Practice Address - Country:US
Practice Address - Phone:732-722-7900
Practice Address - Fax:732-722-7899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty