Provider Demographics
NPI:1316064736
Name:ROBERT I NEUFELD DPM LLC
Entity type:Organization
Organization Name:ROBERT I NEUFELD DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR SURGEON PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:IRA
Authorized Official - Last Name:NEUFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-688-0113
Mailing Address - Street 1:2092 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-6022
Mailing Address - Country:US
Mailing Address - Phone:908-688-0113
Mailing Address - Fax:908-688-2002
Practice Address - Street 1:2092 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6022
Practice Address - Country:US
Practice Address - Phone:908-688-0113
Practice Address - Fax:908-688-2002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD01322213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1003101Medicaid
NJ435646Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
NJT44945Medicare UPIN