Provider Demographics
NPI:1730360504
Name:ERIC M DEUTCHMAN, D.P.M.
Entity type:Organization
Organization Name:ERIC M DEUTCHMAN, D.P.M.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:M
Authorized Official - Last Name:DEUTCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-486-3338
Mailing Address - Street 1:706 W SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-5648
Mailing Address - Country:US
Mailing Address - Phone:908-486-3338
Mailing Address - Fax:
Practice Address - Street 1:706 W SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-5648
Practice Address - Country:US
Practice Address - Phone:908-486-3338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD001314NJ213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ480022356OtherRAILROAD MEDICARE PIN
NJ480022356OtherRAILROAD MEDICARE PIN
NJLI461682Medicare PIN