Provider Demographics
NPI:1194188565
Name:REAM, GAREN MICHAEL (DPM)
Entity Type:Individual
Prefix:
First Name:GAREN
Middle Name:MICHAEL
Last Name:REAM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28 THROCKMORTON LN STE 102
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2558
Mailing Address - Country:US
Mailing Address - Phone:732-679-6400
Mailing Address - Fax:732-679-4880
Practice Address - Street 1:28 THROCKMORTON LN STE 102
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2558
Practice Address - Country:US
Practice Address - Phone:732-679-6400
Practice Address - Fax:732-679-4880
Is Sole Proprietor?:No
Enumeration Date:2016-04-01
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006891213E00000X
NJ25MD00355800213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist