Individual
JONATHAN TADROS MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
855 BROADWAY, BAYONNE, NJ 07002-3018
(201) 535-8978
(201) 535-8979
Mailing address
PO BOX 476, COLTS NECK, NJ 07722-0476
(201) 535-8978
(201) 535-8979
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00290800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0514471
—
NJ
Enumeration date
04/11/2007
Last updated
03/29/2023
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