| Boonton Podiatry | |
|
223 W Main St, Suite 1b, Boonton, NJ 07005-1166 | |
| (973) 402-1973 | |
| (973) 402-1969 |
| Full Name | Boonton Podiatry |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 223 W Main St, Boonton, 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 |
|---|---|---|---|
| 1245426337 | NPI | - | NPPES |
| 3444805 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | MD01978 (New Jersey) | Primary |
| Provider Name | Jean M Roniger |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1508836230 PECOS PAC ID: 0345434270 Enrollment ID: I20101104000408 |
| Provider Name | John A Olin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568433654 PECOS PAC ID: 6204920671 Enrollment ID: I20101104000496 |
| Mailing Address | Practice Location Address |
|---|---|
| Boonton Podiatry 223 W Main St, Suite 1b, Boonton, NJ 07005-1166 Ph: (973) 402-1973 | Boonton Podiatry 223 W Main St, Suite 1b, Boonton, NJ 07005-1166 Ph: (973) 402-1973 |
Jean M Roniger, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 223 West Main Street, Suite 1b, Boonton, NJ 07005 Phone: 973-402-1973 Fax: 973-402-1969 | |
John A Olin, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 223 West Main Street, Suite 1b, Boonton, NJ 07005 Phone: 973-402-1973 Fax: 973-402-1969 | |
Hennessy Medical Professional Corporation Podiatrist Medicare: Medicare Enrolled Practice Location: 223 W Main St, Boonton, NJ 07005 Phone: 973-402-1973 Fax: 973-402-1969 |