Provider Demographics
NPI:1376541896
Name:SPERBER, DARA JEANNE (DPM)
Entity Type:Individual
Prefix:DR
First Name:DARA
Middle Name:JEANNE
Last Name:SPERBER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ABBOTT HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08836-2225
Mailing Address - Country:US
Mailing Address - Phone:732-271-9545
Mailing Address - Fax:
Practice Address - Street 1:127 ELMORA AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1692
Practice Address - Country:US
Practice Address - Phone:908-352-3309
Practice Address - Fax:908-352-7961
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00199900213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4625102Medicaid
NJP00076398OtherMEDICARE RAILROAD
NJ4625102Medicaid
NJP00076398OtherMEDICARE RAILROAD