Provider Demographics
NPI:1730365172
Name:ROBERT J WARKALA DPM
Entity type:Organization
Organization Name:ROBERT J WARKALA DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:WARKALA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-582-6082
Mailing Address - Street 1:445 HURFFVILLE CROSSKEYS
Mailing Address - Street 2:B6
Mailing Address - City:SEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08080-2337
Mailing Address - Country:US
Mailing Address - Phone:856-582-6082
Mailing Address - Fax:856-582-6083
Practice Address - Street 1:100 KINGS WAY E STE D6
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2238
Practice Address - Country:US
Practice Address - Phone:856-582-6082
Practice Address - Fax:856-582-6083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD01752213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0746700001Medicare NSC
NJ519022Medicare PIN