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General NPI Number Information
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NPI Number | 1255501938
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Entity Type | Organization
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Legal Business Name | DR. STEVEN MARDER, LLC
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 1049 BROADWAY SUITE 1
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1334
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Country | US
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Telephone | 732-870-9700
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Fax | 732-571-7873
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Provider Business Mailing Address
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Address Line | 1049 BROADWAY SUITE 1
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1334
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Country | US
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Telephone | 732-870-9700
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Fax | 732-571-7873
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN MARDER
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Credential | DPM
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Telephone | 732-870-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 25MD00136800
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License Number State | NJ
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