Provider Demographics
NPI:1003813551
Name:SUBIK, MICHAEL (DPM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SUBIK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1253
Mailing Address - Country:US
Mailing Address - Phone:201-939-9098
Mailing Address - Fax:201-939-5614
Practice Address - Street 1:160 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-1253
Practice Address - Country:US
Practice Address - Phone:201-939-9098
Practice Address - Fax:201-939-5614
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2023-04-10
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-04-04
Provider Licenses
StateLicense IDTaxonomies
NJMD002524213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery