Roselle Podiatry Group, Pa | |
776 E 3rd Ave, Roselle, NJ 07203-1698 | |
(908) 620-3200 | |
(908) 620-1040 |
Full Name | Roselle Podiatry Group, Pa |
---|---|
Type | Facility |
Speciality | Podiatrist - Foot Surgery |
Location | 776 E 3rd Ave, Roselle, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003139031 | NPI | - | NPPES |
4702770001 | Other | NJ | MEDICARE DME |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0131X | Podiatrist - Foot Surgery | MD002426 (New Jersey) | Primary |
Provider Name | Yeon A Shim |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1679504302 PECOS PAC ID: 1153456934 Enrollment ID: I20100318000379 |
Mailing Address | Practice Location Address |
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Roselle Podiatry Group, Pa 776 E 3rd Ave, Roselle, NJ 07203-1698 Ph: (908) 620-3200 | Roselle Podiatry Group, Pa 776 E 3rd Ave, Roselle, NJ 07203-1698 Ph: (908) 620-3200 |
Lloyd Harris, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 2305 Wood Ave, Roselle, NJ 07203 Phone: 908-241-1727 Fax: 908-241-0053 | |
Yeon A Shim, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1305 Saint George Ave, Roselle, NJ 07203 Phone: 908-620-3200 Fax: 908-620-1040 | |
Dynamic Foot & Ankle Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 776 E 3rd Ave, Roselle, NJ 07203 Phone: 908-280-4314 |