Basic Information
| Provider Information | |||||||||
| NPI: | 1114413416 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OFELDT | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2159 ROUTE 88 E | ||||||||
| Address2: | |||||||||
| City: | BRICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087243232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328990015 | ||||||||
| FaxNumber: | 7328990061 | ||||||||
| Practice Location | |||||||||
| Address1: | 2159 ROUTE 88 E | ||||||||
| Address2: | |||||||||
| City: | BRICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087243232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156125161 | ||||||||
| FaxNumber: | 2156124069 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2018 | ||||||||
| LastUpdateDate: | 09/07/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | SC006956 | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 213ES0103X | 25MD00351400 | NJ | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.