Provider Demographics
NPI:1225066210
Name:DUBNOFF, MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:DUBNOFF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 HOOPER AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8175
Mailing Address - Country:US
Mailing Address - Phone:732-255-4958
Mailing Address - Fax:732-255-0290
Practice Address - Street 1:1868 HOOPER AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8175
Practice Address - Country:US
Practice Address - Phone:732-255-4958
Practice Address - Fax:732-255-0290
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC0484500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ204492983OtherAMERICAN SPECIALTY HEALTH
NJ204492983OtherGALAXY HEALTH NETWORK
NJ204492983OtherMULTIPLAN
NJ2742799000OtherAMERIHEALTH OF NJ
NJ204492983OtherHORIZON BC BS OF NJ
NJ204492983OtherBEECHSTREET
NJP00412115OtherRAILROAD MEDICARE
NJ204492983OtherBEECHSTREET
NJ101877VGNMedicare PIN