Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JAY MARC MICKENBERG, DPM
Deactivated Sole ProprietorDR. JAY MARC MICKENBERG, DPM is a Podiatrist healthcare provider located in PASADENA, Maryland. NPI 1336149962 is deactivated in the NPPES registry. Verify at CMS.
Podiatrist · PASADENA, MD
This NPI has been deactivated.
The record was deactivated on March 21, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1336149962
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 26, 2005 (0.65205479452055 yrs)
- Last Updated
- Feb 21, 2024
- Deactivated
- Mar 21, 2006
- License
-
1053 (MD)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8094 EDWIN RAYNOR BLVDSUITE CPASADENA, MD, 211226834Browse MD providers · Browse ZIP 21122
- Phone
- 4102550040
- Fax
- 4103604955
- Primary Specialty
-
Podiatrist
213E00000X
Other Podiatrist Providers in PASADENA, MD
| Name | Credential | NPI |
|---|---|---|
| DR. ENZO J LEONE | D.P.M. | 1801894241 |
| DR. IRA J GOTTLIEB | D.P.M. | 1265430524 |
| ROSS SAMUEL COHEN | D.P.M. | 1548268485 |
| JOSEPH GERARD PROEBSTLE | D.P.M. | 1972501906 |
| JENNY NGUYEN | DPM | 1255350229 |
| STEVEN ARNOLD GERSH | DPM | 1942313176 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.