Provider Demographics
NPI:1053412791
Name:SYTNER, ARI (DPM)
Entity type:Individual
Prefix:DR
First Name:ARI
Middle Name:
Last Name:SYTNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:DR
Other - First Name:LEON
Other - Middle Name:
Other - Last Name:SYTNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:25 INNESS RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2714
Mailing Address - Country:US
Mailing Address - Phone:201-266-4256
Mailing Address - Fax:
Practice Address - Street 1:100 STATE ST
Practice Address - Street 2:SUITE 2D
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-5200
Practice Address - Country:US
Practice Address - Phone:201-837-0270
Practice Address - Fax:201-837-9776
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002329213ES0131X
NYN005262213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1416399OtherUNITED HEALTHCARE
NJPH1551OtherBLUC CROSS
NJ107611OtherAMERIGROUP
NJ2K30585OtherHEALTHNET
NJ7000308Medicaid
NJP1016634OtherOXFORD
NJ6201413OtherGHI
NJU60715Medicare UPIN
NJP1016634OtherOXFORD