Healthcare Provider Details

I. General information

NPI: 1417914276
Provider Name (Legal Business Name): STEVEN PALDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 EASTON AVE
NEW BRUNSWICK NJ
08901-1766
US

IV. Provider business mailing address

254 EASTON AVE P.O. BOX 591
NEW BRUNSWICK NJ
08901-1766
US

V. Phone/Fax

Practice location:
  • Phone: 732-565-5482
  • Fax: 732-249-5284
Mailing address:
  • Phone: 732-565-5482
  • Fax: 732-249-5284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberMA59954
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: