Healthcare Provider Details

I. General information

NPI: 1982847612
Provider Name (Legal Business Name): STEVEN JAY DOLGOFF DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2009
Last Update Date: 08/20/2023
Certification Date: 08/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SOUTH FIRST AVE
GALLOWAY NJ
08205-9508
US

IV. Provider business mailing address

4247 HIGHWAY 1008
LITTLE RIVER SC
29566-7619
US

V. Phone/Fax

Practice location:
  • Phone: 732-567-8251
  • Fax:
Mailing address:
  • Phone: 732-567-8251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00151600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number25MD00151600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: