| Garden State Podiatry, Llc | |
|
4 E High St, Bound Brook, NJ 08805-1946 | |
| (732) 537-9200 | |
| (732) 356-3750 |
| Full Name | Garden State Podiatry, Llc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | 4 E High St, Bound Brook, 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 |
|---|---|---|---|
| 1194084640 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | (New Jersey) | Primary |
| Provider Name | Ujjwal Datta |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1760486385 PECOS PAC ID: 4486641800 Enrollment ID: I20040512000040 |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Podiatry, Llc 4 E High St, Bound Brook, NJ 08805-1946 Ph: (732) 537-9200 | Garden State Podiatry, Llc 4 E High St, Bound Brook, NJ 08805-1946 Ph: (732) 537-9200 |
Dr. Roy Robert Henderson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 60 West Union Ave, Bound Brook, NJ 08805 Phone: 732-469-3668 Fax: 732-469-3650 | |
Dr. Ujjwal Kumar Datta, DPM Podiatrist Medicare: May Accept Medicare Assignments Practice Location: 4 E High St, Bound Brook, NJ 08805 Phone: 732-537-9200 Fax: 732-356-3750 |