Healthcare Provider Details

I. General information

NPI: 1962567172
Provider Name (Legal Business Name): MICHAEL T DRESDNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 VALLEY ST
SOUTH ORANGE NJ
07079-2886
US

IV. Provider business mailing address

106 VALLEY ST
SOUTH ORANGE NJ
07079-2886
US

V. Phone/Fax

Practice location:
  • Phone: 973-763-4334
  • Fax:
Mailing address:
  • Phone: 973-763-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMA09392400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberMA06392400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: