ACTIVE PODIATRY LLC (NPI# 1093217622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093217622 |
| Entity Type | Organization |
| Organization Name | ACTIVE PODIATRY LLC |
| Other Organization Name | ACTIVE PODIATRY LLC |
| Practice Address |
7823 Bergenline Ave Fl 2 North Bergen NJ 07047-4942 |
| Mailing Address |
Po Box 4293 Wayne NJ 07474-4293 |
| Practice Telephone | 2016143668 |
| Practice Fax Number | 9732564757 |
| Mailing Telephone | 2016143668 |
| Mailing Fax Number | 9732564757 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | HOMAM BADRI (DPM) |
| Authorized Official Telephone | 2016143668 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
25MD0032100 | NJ | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0429732 | 05 |
| Other Name | Type Code |
|---|---|
| Active Podiatry LLC | Doing Business As Name - Organization |
| Street Address |
7823 BERGENLINE AVE FL 2 |
| City | NORTH BERGEN |
| State | NJ |
| Zip Code | 07047-4942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376046276 | Royale Foot and Ankle Surgeons | Podiatrist | 7823 Bergenline Ave Fl 2, North Bergen, NJ 07047-4942 | 2018-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447850490 | Maria Purita Yballe | Nurse Practitioner | 8100 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2020-10-29 |
| 1639799646 | Red Oak Pharmacy Corp | Pharmacy | 9225 John F Kennedy Blvd, Unit F, North Bergen, NJ 07047 | 2020-04-20 |
| 1811520091 | Andres A Varilias | Pharmacist | 7917 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2020-02-17 |
| 1669016986 | Rebecca Lee | Dentist | 3123 John F. Kennedy Blvd, North Bergen, NJ 07047 | 2019-10-30 |
| 1720648439 | Hannah Joy Guharajan | Speech-Language Pathologist | 5665 John F. Kennedy Blvd, Apt. 508, North Bergen, NJ 07047 | 2019-06-14 |
| 1417417080 | Chandini Sajja | Student in an Organized Health Care Education/Training Program | 7600 River Road, North Bergen, NJ 07047 | 2019-03-20 |
| 1215455522 | Xavier Steven Alzate | Specialist/Technologist | 338 75th Street, 2b, North Bergen, NJ 07047 | 2017-09-07 |
| 1962923151 | Hala Altunji | Dentist | 8407 Jfk Blvd E, North Bergen, NJ 07047 | 2017-06-28 |
| 1871023457 | Diego Nieto | Specialist | 6112 Durham Ave, North Bergen, NJ 07047 | 2017-06-15 |
| 1326578105 | Hudson Hills Senior Living, LLC | Nursing Care | 3505 Bergen Tpke, North Bergen, NJ 07047 | 2017-06-14 |
| Find all providers in zip 07047 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609822360 | Ketan D. Shah | Podiatrist | 9234 Kennedy Blvd, North Bergen, NJ 07047-5312 | 2006-05-25 |
| 1467429324 | Peter John Iannuzzi | Podiatrist | 7817 Bergenline Ave, North Bergen, NJ 07047-4942 | 2006-02-28 |
| 1144200445 | Demetrios S Econopouly | Podiatrist | 9226 Kennedy Blvd, 2nd Floor, North Bergen, NJ 07047-5312 | 2006-01-20 |
| 1619595659 | Dr Dina Ibrahim Foot & Ankle Surgery LLC | Podiatrist | 7600 River Rd, North Bergen, NJ 07047-6217 | 2020-07-07 |
| 1376046276 | Royale Foot and Ankle Surgeons | Podiatrist | 7823 Bergenline Ave Fl 2, North Bergen, NJ 07047-4942 | 2018-03-16 |
| 1396926119 | A Center for Foot and Ankle Surgery, P.a. | Podiatrist | 7521 Bergenline Ave, North Bergen, NJ 07047-5459 | 2007-11-20 |
| 1437293958 | Dpm0016mllc | Podiatrist | 7406 Bergenline Ave, North Bergen, NJ 07047-5449 | 2007-02-17 |
| 1447287511 | Luis Leal | Podiatrist | 7600 River Rd, 2nd Floor, North Bergen, NJ 07047-6217 | 2006-06-26 |
| 1285672022 | Franklin N. Levinson | Podiatrist | 9234 Kennedy Blvd, North Bergen, NJ 07047-5312 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350120 | Lower Limb Institute | Podiatrist | 211 Esses Street, Suite 405, Hackesack, NJ 07601 | 2020-09-09 |
| 1275162315 | Mercer-ocean Podiatry | Podiatrist | 666 Plainsboro Rd Ste 1050, Plainsboro, NJ 08536-3044 | 2020-04-01 |
| 1386279552 | Liberty Med Associates LLC | Podiatrist | 1 Bethany Rd Ste 21, Hazlet, NJ 07730-1660 | 2020-03-09 |
| 1659905685 | New Jersey Podiatric Physicians & Surgeons Group LLC | Podiatrist | 132 Franklin Corner Rd Ste C1, Lawrenceville, NJ 08648-2523 | 2020-02-28 |
| 1891270609 | Syracuse Medical LLC | Podiatrist | 5 Franklin Ave Ste 103, Belleville, NJ 07109-3521 | 2018-09-27 |
| 1912481946 | Dr Emad Youssef Podiatry LLC | Podiatrist | 14 W 11th St Fl 1, Bayonne, NJ 07002-2508 | 2018-09-14 |
| 1932686334 | Kinetic Foot and Ankle, LLC | Podiatrist | 1030 Mcbride Ave Unit 103, Woodland Park, NJ 07424-2535 | 2018-07-27 |
| 1346730215 | J M Podiatry Associates PC | Podiatrist | 121 Route 31 Ste 700, Flemington, NJ 08822-5754 | 2018-05-15 |
| 1235629783 | Belvidere Foot & Ankle LLC | Podiatrist | 8 Greenwich St, Belvidere, NJ 07823-1421 | 2018-05-10 |
| 1922507003 | Muntasir Khaled | Podiatrist | 417 Memorial Pkwy, Bloomfield, NJ 07003-4266 | 2018-02-05 |
| Find all providers with the same taxonomy | ||||
| City | NORTH BERGEN |
| Zip Code | 07047 |
Please comment or provide details below to improve the information on ACTIVE PODIATRY LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.