Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | MD002524 | NJ |
NPI | 1003813551 |
---|---|
Provider Name | Michael Subik |
First Address | Lyndhurst, NJ 07071-1253 |
Second Address | Lyndhurst, NJ 07071-1253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2005 |
Last Update Date | 25/02/2013 |