Provider Demographics
NPI:1154304269
Name:POLING, STEVEN N (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:N
Last Name:POLING
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 1:240 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2323
Mailing Address - Country:US
Mailing Address - Phone:201-460-1555
Mailing Address - Fax:201-460-8090
Practice Address - Street 1:240 PARK AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-2323
Practice Address - Country:US
Practice Address - Phone:201-460-1555
Practice Address - Fax:201-460-8090
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00164000213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF10710OtherHEALTHNET
NJ1613707Medicaid
T45306Medicare UPIN
NJ1613707Medicaid