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General NPI Number Information
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NPI Number | 1861944266
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Entity Type | Organization
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Legal Business Name | STEVEN I GUBERNICK, DPM
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Dates
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Enumeration Date | 11/01/2016
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 2766 PRINCETON PIKE
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-3221
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Country | US
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Telephone | 609-538-8331
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Fax |
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Provider Business Mailing Address
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Address Line | 2766 PRINCETON PIKE
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-3221
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Country | US
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Telephone | 609-538-8331
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Fax |
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Authorized Official
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Title or Position | PODIATRIST
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Name | STEVEN GUBERNICK
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Credential | DPM MS
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Telephone | 609-538-8331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number | MD002111
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License Number State | NJ
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