| Innovative Foot And Ankle, P.a. | |
|
528 Boulevard, Kenilworth, NJ 07033-1657 | |
| (908) 276-6624 | |
| (908) 709-0163 |
| Full Name | Innovative Foot And Ankle, P.a. |
|---|---|
| Type | Facility |
| Speciality | Podiatrist - Primary Podiatric Medicine |
| Location | 528 Boulevard, Kenilworth, 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 |
|---|---|---|---|
| 1023177532 | NPI | - | NPPES |
| 8719501 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213EP1101X | Podiatrist - Primary Podiatric Medicine | 25MD00261900 (New Jersey) | Primary |
| Provider Name | Michael Rallatos |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1962431445 PECOS PAC ID: 3072526953 Enrollment ID: I20060718000283 |
| Provider Name | Joseph G Cabrera |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1861475972 PECOS PAC ID: 7618871161 Enrollment ID: I20070402000706 |
| Provider Name | Sean L Kaufman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821091018 PECOS PAC ID: 1951314806 Enrollment ID: I20100527000584 |
| Provider Name | Vasiliki Rallatos-drake |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639417363 PECOS PAC ID: 3072758200 Enrollment ID: I20130318000303 |
| Provider Name | Ashley Bittar |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1700239506 PECOS PAC ID: 4284968942 Enrollment ID: I20190628002274 |
| Provider Name | Rachel Maslow |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1073046108 PECOS PAC ID: 3173934387 Enrollment ID: I20201119000724 |
| Provider Name | Pooja Shah |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1821520933 PECOS PAC ID: 1951725910 Enrollment ID: I20240829004146 |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Foot And Ankle, P.a. 528 Boulevard, Kenilworth, NJ 07033-1657 Ph: (908) 276-6624 | Innovative Foot And Ankle, P.a. 528 Boulevard, Kenilworth, NJ 07033-1657 Ph: (908) 276-6624 |
Dr. Sean L. Kaufman, D.P.M Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 528 Boulevard, Kenilworth, NJ 07033 Phone: 908-276-6624 Fax: 908-709-0163 | |
Dr. Michael Rallatos, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 528 Boulevard, Kenilworth, NJ 07033 Phone: 908-276-6624 Fax: 908-709-0163 |