Basic Information
| Provider Information | |||||||||
| NPI: | 1659512523 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | STEVEN M DRIBBON DPM PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 503 RARITAN AVE | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089042901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325720020 | ||||||||
| FaxNumber: | 7325720688 | ||||||||
| Practice Location | |||||||||
| Address1: | 503 RARITAN AVE | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089042901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7325720020 | ||||||||
| FaxNumber: | 7325720688 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2009 | ||||||||
| LastUpdateDate: | 05/21/2013 | ||||||||
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| AuthorizedOfficialLastName: | DRIBBON | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7325720020 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DPM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0103X | 25MD0122000 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery |
No ID Information.