Healthcare Provider Details

I. General information

NPI: 1083085195
Provider Name (Legal Business Name): JORDAN STEINBERG D.P.M. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2015
Last Update Date: 10/28/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 HANOVER RD SUITE 160
FLORHAM PARK NJ
07932-1508
US

IV. Provider business mailing address

227 MILLBURN AVE
MILLBURN NJ
07041
US

V. Phone/Fax

Practice location:
  • Phone: 973-922-0464
  • Fax:
Mailing address:
  • Phone: 228-366-4335
  • Fax: 866-716-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00322300
License Number StateNJ

VIII. Authorized Official

Name: TARAMICHELLE CRAFT
Title or Position: CREDENTIALING CLERK
Credential:
Phone: 228-366-4335