Doctor Name: | MICHAEL SUBIK |
NPI Number: | 1003813551 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.M. |
License Number: | MD002524 |
Business Practice Address: | 160 Ridge Rd Lyndhurst, NJ - 070711253 |
Business Phone Number: | 2019399098 |
Business Fax Number: | 2019395614 |
Mailing Address: | 160 Ridge Rd, LYNDHURST |
State: | NJ |
Postal Code: | 070711253 |
Phone Number: | 2019399098 |
Fax Number: | 2019395614 |
NPI Enumeration Date: | 06/30/2005 |
NPI Last Update Date: | 02/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/17/2006 |
NPI Reactivation Date: | 04/04/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | MD002524 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |