Healthcare Provider Details

I. General information

NPI: 1720248438
Provider Name (Legal Business Name): JAIME GARBER D.P.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 STATE ROUTE 17M
MONROE NY
10950-4123
US

IV. Provider business mailing address

115 FRANKLIN TPKE STE 291
MAHWAH NJ
07430-1325
US

V. Phone/Fax

Practice location:
  • Phone: 845-507-0477
  • Fax: 201-252-8389
Mailing address:
  • Phone: 845-637-2778
  • Fax: 949-543-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00295800
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN006286-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: