Healthcare Provider Details

I. General information

NPI: 1790778405
Provider Name (Legal Business Name): JEFFREY STEVEN DOBRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 JACKSON AVE
POMPTON PLAINS NJ
07444-1453
US

IV. Provider business mailing address

18 SOUTHVIEW DR
BOONTON NJ
07005-9428
US

V. Phone/Fax

Practice location:
  • Phone: 973-835-2575
  • Fax: 973-835-0531
Mailing address:
  • Phone: 973-263-0372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number25MA04148300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: