location
search-icon
person
Jason Gannon, DPM
Foot Surgery Podiatrist in Newark, New Jersey
NPI 1619992690

Jason Gannon is a Foot Surgery Podiatrist based in Edison, NJ and is specialized in Foot Surgery. Jason Gannon practices in Newark, NJ and has the professional credentials of DPM. The NPI Number for Jason Gannon is 1619992690 and holds a License No. 25MD00257500 (New Jersey).

The current practice location address for Jason Gannon is 111 Mulberry St, Newark, NJ and can be reached out via phone at 973-818-9104.

Location: 111 Mulberry St, Newark, NJ, 08837-3205
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619992690
Provider Name
Jason Gannon
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
111 Mulberry St, Newark, NJ, 08837-3205
Phone Number
973-818-9104
Fax Number
Provider Enumeration Date
07/12/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
8238502 05 NJ
institution
Provider Business Practice Location Address Details
Address
111 Mulberry St
City
Newark
State
New Jersey
Zip
07102-4008
Phone Number
973-818-9104
Fax Number
person
Provider Business Mailing Address Details
Address
111 Mulberry St
City
Newark
State
New Jersey
Zip
07102-4008
Phone Number
973-818-9104
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
213ES0131X
License No.
25MD00257500 (New Jersey)
Definition
Definition to come...
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.