Organization · NPI-2
Progressive Podiatry Of North Jersey
Podiatrist · Edgewater, NJ
NPI number1508050139
StatusActive
Last updated in NPPESApr 22, 2011
Details
- NPI
- 1508050139
- Entity type
- Organization (NPI-2)
- Legal business name
- Progressive Podiatry Of North Jersey
- Organization subpart
- No
- Enumeration date
- Aug 27, 2007
- Last updated
- Apr 22, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213E00000X | Podiatrist | 25md00272100 | NJ | Yes |
Practice location
725 River RdSuite 201-A
Edgewater, NJ 07020-1171
Phone 201-840-7373 · Fax 201-840-7383
Mailing address
725 River RdSuite 201-A
Edgewater, NJ 07020-1171
Phone 201-840-7373 · Fax 201-840-7383
Authorized official
Corinne Jeanette Gehegan
Sole Owner
2018407373
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