Healthcare Provider Details

I. General information

NPI: 1790009538
Provider Name (Legal Business Name): STEVEN M. DRIBBON, DPM, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2010
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 RARITAN AVE
HIGHLAND PARK NJ
08904-2901
US

IV. Provider business mailing address

503 RARITAN AVE
HIGHLAND PARK NJ
08904-2901
US

V. Phone/Fax

Practice location:
  • Phone: 732-572-0020
  • Fax: 732-572-0688
Mailing address:
  • Phone: 732-572-0020
  • Fax: 732-572-0688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00122000
License Number StateNJ

VIII. Authorized Official

Name: DR. STEVEN M DRIBBON
Title or Position: OWNER
Credential: DPM
Phone: 732-572-0020